hospital_name,last_updated_on,version,location_name,hospital_address,license_number|NC,type_2_npi,"To the best of its knowledge and belief, this 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 in the file. This hospital has included all payer-specific negotiated charges in dollars that can be expressed as a dollar amount. For payer-specific negotiated charges that cannot be expressed as a dollar amount in the machine-readable file or not knowable in advance, the hospital attests that the payer-specific negotiated charge is based on a contractual algorithm, percentage or formula that precludes the provision of a dollar amount and has provided all necessary information available to the hospital for the public to be able to derive the dollar amount, including, but not limited to, the specific fee schedule or components referenced in such percentage, algorithm or formula.",attester_name,,,,,,,,,,,,,,,
Centennial Housing & Community Services Corporation,8/11/2026,3.0.0,Washington Regional Medical Center,"958 US Hwy 64 East, Plymouth, NC  27962",H0006|NC,1972119782,TRUE,Frank T. Avignone IV,,,,,,,,,,,,,,,
description,code|1,code|1|type,code|2,code|2|type,billing_class,setting,drug_unit_of_measurement,drug_type_of_measurement,modifiers,standard_charge|gross,standard_charge|discounted_cash,standard_charge|Blue Cross and Blue Shield of North Carolina|Blue Options|negotiated_dollar,standard_charge|Blue Cross and Blue Shield of North Carolina|Blue Options|negotiated_percentage,standard_charge|Blue Cross and Blue Shield of North Carolina|Blue Options|negotiated_algorithm,median_amount|Blue Cross and Blue Shield of North Carolina|Blue Options,10th_percentile|Blue Cross and Blue Shield of North Carolina|Blue Options,90th_percentile|Blue Cross and Blue Shield of North Carolina|Blue Options,count|Blue Cross and Blue Shield of North Carolina|Blue Options,standard_charge|Blue Cross and Blue Shield of North Carolina|Blue Options|methodology,additional_payer_notes|Blue Cross and Blue Shield of North Carolina|Blue Options,standard_charge|min,standard_charge|max,additional_generic_notes
OBS 1ST HOUR,500001,CDM,G0378,HCPCS,Facility,both,,,,122.88,61.44,,,,,,,,,,,,
OBS 1ST HR WITH TELEMETRY,500002,CDM,G0378,HCPCS,Facility,both,,,,122.88,61.44,,,,,,,,,,,,
OBS 1ST HR WITH IV'S,500003,CDM,G0378,HCPCS,Facility,both,,,,122.88,61.44,,,,,,,,,,,,
OBS 1ST DAY 1ST HOUR W/IV&TELE,500004,CDM,G0378,HCPCS,Facility,both,,,,122.88,61.44,,,,,,,,,,,,
OBS 1ST DAY @ ADD HR WITH IV,500013,CDM,G0378,HCPCS,Facility,both,,,,122.88,61.44,,,,,,,,,,,,
OBS 1ST DAY @ ADD HR W/IV/TELE,500016,CDM,G0378,HCPCS,Facility,both,,,,122.88,61.44,,,,,,,,,,,,
OBS 1ST DAY @ ADD HR WITH TELE,500021,CDM,G0378,HCPCS,Facility,both,,,,122.88,61.44,,,,,,,,,,,,
OBS 1ST DAY @ ADD HR,501003,CDM,G0378,HCPCS,Facility,both,,,,122.88,61.44,,,,,,,,,,,,
Engerix-B 20 MCG/ML VIAL,564484,CDM,J2201,HCPCS,Facility,both,,,,3,1.5,,,,,,,,,,,,
Pulse Ox/O2 Saturation POC,1019777,CDM,94760,CPT,Facility,outpatient,,,,122,61,,,,,,,,,,,,
RSV POC,1019808,CDM,87420,CPT,Facility,outpatient,,,,91,45.5,,,,,,,,,,,,
I&D Skin Simple/single 10060,1021763,CDM,10060,CPT,Facility,outpatient,,,,406,203,,,,,,,,,,,,
I&D Abscess Complex/mult 10061,1021764,CDM,10061,CPT,Facility,outpatient,,,,967,483.5,,,,,,,,,,,,
I&D Pilonidal Cyst Smple 10080,1021765,CDM,10080,CPT,Facility,outpatient,,,,624,312,,,,,,,,,,,,
Remove FB SC Simple 10120,1021766,CDM,10120,CPT,Facility,outpatient,,,,1765,882.5,,,,,,,,,,,,
I&D Hematoma/seroma/flud 10140,1021768,CDM,10140,CPT,Facility,outpatient,,,,1690,845,,,,,,,,,,,,
Debrd Ecze Skn < 10% Bdy 11000,1021771,CDM,11000,CPT,Facility,outpatient,,,,147,73.5,,,,,,,,,,,,
Dbrd SC Tis < = 20 sq cm 11042,1021772,CDM,11042,CPT,Facility,outpatient,,,,1170,585,,,,,,,,,,,,
Remove Skin Tags < = 15 11200,1021778,CDM,11200,CPT,Facility,outpatient,,,,259,129.5,,,,,,,,,,,,
Shave Lsn SNHF 1.1-2.0cm 11307,1021800,CDM,11307,CPT,Facility,outpatient,,,,281,140.5,,,,,,,,,,,,
Avulse Nail Plate Single 11730,1021840,CDM,11730,CPT,Facility,outpatient,,,,215,107.5,,,,,,,,,,,,
Evacuate Subungual Hemtm 11740,1021842,CDM,11740,CPT,Facility,outpatient,,,,121.28,60.64,,,,,,,,,,,,
Exc Nail & Mtrx Partl/cp 11750,1021843,CDM,11750,CPT,Facility,outpatient,,,,642,321,,,,,,,,,,,,
Simp Rpr SNATE< = 2.5cm 12001,1021848,CDM,12001,CPT,Facility,outpatient,,,,403,201.5,,,,,,,,,,,,
Simp Rep SNA 20.1-30.0cm 12006,1021850,CDM,12006,CPT,Facility,outpatient,,,,1008,504,,,,,,,,,,,,
Smp Rep SNATGE 2.5-7.5cm 12002,1021852,CDM,12002,CPT,Facility,outpatient,,,,493,246.5,,,,,,,,,,,,
Simp RepFENLEM <= 2.5 cm 12011,1021853,CDM,12011,CPT,Facility,outpatient,,,,216.88,108.44,,,,,,,,,,,,
Simp RepFENLEM 2.6-5.0cm 12013,1021854,CDM,12013,CPT,Facility,outpatient,,,,709,354.5,,,,,,,,,,,,
INT Rp s/a/t/ex  <=2.5cm 12031,1021859,CDM,12031,CPT,Facility,outpatient,,,,583.96,291.98,,,,,,,,,,,,
INT Rp s/a/t/e 2.6-7.5cm 12032,1021860,CDM,12032,CPT,Facility,outpatient,,,,730.12,365.06,,,,,,,,,,,,
INT Rp s/a/t/e 7.6-12.5cm12034,1021861,CDM,12034,CPT,Facility,outpatient,,,,794.32,397.16,,,,,,,,,,,,
INT Rp s/a/t/e12.6-20.0cm12035,1021862,CDM,12035,CPT,Facility,outpatient,,,,1252,626,,,,,,,,,,,,
INT Rp N/h/f/g <=2.5cm 12041,1021864,CDM,12041,CPT,Facility,outpatient,,,,568,284,,,,,,,,,,,,
INT Rp n/h/f/g 2.6-7.5cm 12042,1021865,CDM,12042,CPT,Facility,outpatient,,,,687,343.5,,,,,,,,,,,,
INT Rp face/mm 2.6-5.0cm 12052,1021911,CDM,12052,CPT,Facility,outpatient,,,,769.8,384.9,,,,,,,,,,,,
INT Rp Face/mm 5.1-7.5cm 12053,1021913,CDM,12053,CPT,Facility,outpatient,,,,828,414,,,,,,,,,,,,
INT Rep Face/mm <=2.5cm 12051,1021915,CDM,12051,CPT,Facility,outpatient,,,,653.44,326.72,,,,,,,,,,,,
FEMUR MIN 2 VIEWS LT,2000043,CDM,73552,CPT,Facility,both,,,,242,121,,,,,,,,,,,,
FEMUR MIN 2 VIEWS RT,2000046,CDM,73552,CPT,Facility,both,,,,242,121,,,,,,,,,,,,
XR CHEST 1V,2000048,CDM,71045,CPT,Facility,both,,,,445,222.5,,,,,,,,,,,,
XR CHEST 2V,2000066,CDM,71046,CPT,Facility,both,,,,509,254.5,,,,,,,,,,,,
XR KUB PORTABLE,2000071,CDM,74018,CPT,Facility,both,,,,357,178.5,,,,,,,,,,,,
XR ABDOMEN MIN 2V,2000072,CDM,74019,CPT,Facility,both,,,,380,190,,,,,,,,,,,,
SPINE THORACIC 2 VIEWS,2000075,CDM,72070,CPT,Facility,both,,,,333.57,166.79,,,,,,,,,,,,
SPINE THORACIC MIN 4 VIEWS,2000077,CDM,72074,CPT,Facility,both,,,,333.57,166.79,,,,,,,,,,,,
FINGER LT 5TH DIGIT MIN 2 VIEW,2001001,CDM,73140,CPT,Facility,both,,,,242,121,,,,,,,,,,,,
FINGER LT 4TH DIGIT MIN 2 VIEW,2001002,CDM,73140,CPT,Facility,both,,,,242,121,,,,,,,,,,,,
FINGER LT 3RD DIGIT MIN 2 VIEW,2001003,CDM,73140,CPT,Facility,both,,,,242,121,,,,,,,,,,,,
FINGER LT 2ND DIGIT MIN 2 VIEW,2001004,CDM,73140,CPT,Facility,both,,,,242,121,,,,,,,,,,,,
"FOREARM, 2V LT",2001005,CDM,73090,CPT,Facility,both,,,,285,142.5,,,,,,,,,,,,
"ELBOW, 2 VIEWS LT",2001006,CDM,73070,CPT,Facility,both,,,,240,120,,,,,,,,,,,,
"ELBOW, 3+VIEWS LT",2001007,CDM,73080,CPT,Facility,both,,,,301,150.5,,,,,,,,,,,,
"HUMERUS, MIN 2V LT",2001008,CDM,73060,CPT,Facility,both,,,,281,140.5,,,,,,,,,,,,
"HAND, MIN 3V LT",2001009,CDM,73130,CPT,Facility,both,,,,243,121.5,,,,,,,,,,,,
"HEEL (CALCANEUS), MIN 2V LT",2001011,CDM,73650,CPT,Facility,both,,,,229,114.5,,,,,,,,,,,,
RIBS W/PA CHEST LT,2001012,CDM,71101,CPT,Facility,both,,,,364,182,,,,,,,,,,,,
RIBS LT,2001013,CDM,71100,CPT,Facility,both,,,,275,137.5,,,,,,,,,,,,
"VENOGRAM, EXTREMITY LT",2001014,CDM,75820,CPT,Facility,both,,,,659,329.5,,,,,,,,,,,,
"TIB-FIB, 2V LT",2001016,CDM,73590,CPT,Facility,both,,,,281,140.5,,,,,,,,,,,,
"FOOT, 2 VIEWS LT",2001017,CDM,73620,CPT,Facility,both,,,,216,108,,,,,,,,,,,,
"FOOT, 2 VIEWS RT",2001018,CDM,73620,CPT,Facility,both,,,,216,108,,,,,,,,,,,,
"FOOT, 3 VIEWS LT",2001019,CDM,73630,CPT,Facility,both,,,,367,183.5,,,,,,,,,,,,
"ANKLE, 2 VIEWS LT",2001020,CDM,73600,CPT,Facility,both,,,,216,108,,,,,,,,,,,,
"ANKLE, 2 VIEWS RT",2001021,CDM,73600,CPT,Facility,both,,,,216,108,,,,,,,,,,,,
"ANKLE, 3 VIEWS LT",2001022,CDM,73610,CPT,Facility,both,,,,270,135,,,,,,,,,,,,
"LOW EXT, INFANT 2V LT",2001023,CDM,73592,CPT,Facility,both,,,,199,99.5,,,,,,,,,,,,
"LOW EXT, INFANT 2V RT",2001024,CDM,73592,CPT,Facility,both,,,,199,99.5,,,,,,,,,,,,
"UP EXTM, INFANT 2V LT",2001025,CDM,73092,CPT,Facility,both,,,,174,87,,,,,,,,,,,,
"UP EXTM, INFANT 2V RT",2001026,CDM,73092,CPT,Facility,both,,,,174,87,,,,,,,,,,,,
CLAVICLE LT,2001027,CDM,73000,CPT,Facility,both,,,,240,120,,,,,,,,,,,,
SCAPULA LT,2001028,CDM,73010,CPT,Facility,both,,,,269,134.5,,,,,,,,,,,,
"SHOULDER, 1 VIEW LT",2001029,CDM,73020,CPT,Facility,both,,,,275,137.5,,,,,,,,,,,,
"SHOULDER, 1 VIEW RT",2001030,CDM,73020,CPT,Facility,both,,,,275,137.5,,,,,,,,,,,,
"SHOULDER, 2+VIEWS LT",2001031,CDM,73030,CPT,Facility,both,,,,310,155,,,,,,,,,,,,
"WRIST, 2 VIEWS LT",2001032,CDM,73100,CPT,Facility,both,,,,267,133.5,,,,,,,,,,,,
"WRIST, 2 VIEWS RT",2001033,CDM,73100,CPT,Facility,both,,,,267,133.5,,,,,,,,,,,,
"WRIST, 3 VIEWS LT",2001034,CDM,73110,CPT,Facility,both,,,,275,137.5,,,,,,,,,,,,
"KNEE, 4+ VIEWS LT",2001035,CDM,73564,CPT,Facility,both,,,,295,147.5,,,,,,,,,,,,
"KNEE, 3 VIEWS LT",2001036,CDM,73562,CPT,Facility,both,,,,318,159,,,,,,,,,,,,
"KNEE, LMT 1-2 VIEWS LT",2001037,CDM,73560,CPT,Facility,both,,,,242,121,,,,,,,,,,,,
CHOLANGIOGRAM-OR ADD,2001040,CDM,74301,CPT,Facility,both,,,,165,82.5,,,,,,,,,,,,
RAD EXAM UPR GI TRC DBL CONT,2001041,CDM,74246,CPT,Facility,both,,,,491,245.5,,,,,,,,,,,,
RAD SMALL INTESTINE FT STUDY,2001042,CDM,74248,CPT,Facility,both,,,,642,321,,,,,,,,,,,,
BONE SURVEY-INFANT,2001045,CDM,77076,CPT,Facility,both,,,,518,259,,,,,,,,,,,,
"BONE SURV, METAS, COMP",2001046,CDM,77075,CPT,Facility,both,,,,431,215.5,,,,,,,,,,,,
"BONE SURV, METAST, LMT",2001047,CDM,77074,CPT,Facility,both,,,,274,137,,,,,,,,,,,,
PELVIS W/OBLIQUES 3V,2001050,CDM,72190,CPT,Facility,both,,,,293,146.5,,,,,,,,,,,,
SPINE CERV COMP >6 VIEWS,2001051,CDM,72052,CPT,Facility,both,,,,502,251,,,,,,,,,,,,
IVP 100 CC,2001052,CDM,74400,CPT,Facility,both,,,,610,305,,,,,,,,,,,,
"KNEE, 3 VIEWS RT",2001053,CDM,73562,CPT,Facility,both,,,,318,159,,,,,,,,,,,,
"MANDIBLE, 4 VIEWS",2001054,CDM,70110,CPT,Facility,both,,,,298,149,,,,,,,,,,,,
MASTOIDS < 3V PER SIDE,2001055,CDM,70120,CPT,Facility,both,,,,298,149,,,,,,,,,,,,
"NOSE, 3+ VIEWS",2001056,CDM,70160,CPT,Facility,both,,,,256,128,,,,,,,,,,,,
ORBIT BILATERAL RT/LT,2001058,CDM,70200,CPT,Facility,both,,,,385,192.5,,,,,,,,,,,,
"HEEL (CALCANEUS), MIN 2V RT",2001059,CDM,73650,CPT,Facility,both,,,,229,114.5,,,,,,,,,,,,
PELVIS-AP,2001060,CDM,72170,CPT,Facility,both,,,,281,140.5,,,,,,,,,,,,
RIBS RT,2001063,CDM,71100,CPT,Facility,both,,,,275,137.5,,,,,,,,,,,,
"RIBS BILAT, 3 VIEWS",2001064,CDM,71110,CPT,Facility,both,,,,728,364,,,,,,,,,,,,
"SACROILLIAC, 3+ VIEWS",2001065,CDM,72202,CPT,Facility,both,,,,229,114.5,,,,,,,,,,,,
SACRUM & COCCYX 2T,2001066,CDM,72220,CPT,Facility,both,,,,281,140.5,,,,,,,,,,,,
SCAPULA RT,2001067,CDM,73010,CPT,Facility,both,,,,269,134.5,,,,,,,,,,,,
SELLA TURCICA,2001068,CDM,70240,CPT,Facility,both,,,,132,66,,,,,,,,,,,,
"SHOULDER, 2+VIEWS RT",2001070,CDM,73030,CPT,Facility,both,,,,310,155,,,,,,,,,,,,
"SINUSES, 3 VIEWS",2001072,CDM,70220,CPT,Facility,both,,,,189,94.5,,,,,,,,,,,,
SKULL AP & LAT,2001073,CDM,70250,CPT,Facility,both,,,,256,128,,,,,,,,,,,,
SKULL COMPLETE,2001074,CDM,70260,CPT,Facility,both,,,,263,131.5,,,,,,,,,,,,
SPINE CERV 2-3 VIEWS,2001075,CDM,72040,CPT,Facility,both,,,,328,164,,,,,,,,,,,,
SPINE CERV 4/5 VIEWS,2001076,CDM,72050,CPT,Facility,both,,,,491,245.5,,,,,,,,,,,,
SPINE LUMBAR 2 OR 3 VIEWS,2001077,CDM,72100,CPT,Facility,both,,,,398,199,,,,,,,,,,,,
SPINE LUMBAR MIN 4V,2001078,CDM,72110,CPT,Facility,both,,,,632,316,,,,,,,,,,,,
SPINE THORACIC 3 VIEWS,2001080,CDM,72072,CPT,Facility,both,,,,351,175.5,,,,,,,,,,,,
TMJ BILAT,2001082,CDM,70330,CPT,Facility,both,,,,243,121.5,,,,,,,,,,,,
"TIB-FIB, 2V RT",2001083,CDM,73590,CPT,Facility,both,,,,281,140.5,,,,,,,,,,,,
GREAT TOE LT,2001084,CDM,73660,CPT,Facility,both,,,,229,114.5,,,,,,,,,,,,
TOMOGRAM,2001085,CDM,76100,CPT,Facility,both,,,,254,127,,,,,,,,,,,,
"VENOGRAM, EXTREMITY RT",2001087,CDM,75820,CPT,Facility,both,,,,659,329.5,,,,,,,,,,,,
"WRIST, 3 VIEWS RT",2001088,CDM,73110,CPT,Facility,both,,,,275,137.5,,,,,,,,,,,,
SWALLOWING FUNC,2001090,CDM,74230,CPT,Facility,both,,,,636,318,,,,,,,,,,,,
"AC JT BIL, W/WO WEIGHT DIST",2001094,CDM,73050,CPT,Facility,both,,,,215,107.5,,,,,,,,,,,,
"ANKLE, 3 VIEWS RT",2001095,CDM,73610,CPT,Facility,both,,,,270,135,,,,,,,,,,,,
BE AIR CONTRAST,2001096,CDM,74280,CPT,Facility,both,,,,1000,500,,,,,,,,,,,,
PHARYNX AND/OR CERV,2001097,CDM,74210,CPT,Facility,both,,,,285,142.5,,,,,,,,,,,,
CHOLANGIOGRAPHY OR PANCREATOG,2001105,CDM,74300,CPT,Facility,both,,,,448,224,,,,,,,,,,,,
CLAVICLE RT,2001106,CDM,73000,CPT,Facility,both,,,,240,120,,,,,,,,,,,,
COCCYX,2001107,CDM,72220,CPT,Facility,both,,,,141,70.5,,,,,,,,,,,,
NEPHROTOMOGRAM,2001108,CDM,74415,CPT,Facility,both,,,,585,292.5,,,,,,,,,,,,
VOIDING CYSTOGR,2001109,CDM,74455,CPT,Facility,both,,,,518,259,,,,,,,,,,,,
"ELBOW, 3+ VIEWS RT",2001110,CDM,73080,CPT,Facility,both,,,,301,150.5,,,,,,,,,,,,
"KNEE, 4+ VIEWS RT",2001111,CDM,73564,CPT,Facility,both,,,,295,147.5,,,,,,,,,,,,
"FACIAL BONES, >3 VIEW",2001112,CDM,70150,CPT,Facility,both,,,,308,154,,,,,,,,,,,,
"THUMB LT, MIN 2 VIEW",2001114,CDM,73140,CPT,Facility,both,,,,242,121,,,,,,,,,,,,
"FOOT, 3 VIEWS RT",2001116,CDM,73630,CPT,Facility,both,,,,367,183.5,,,,,,,,,,,,
"FOREARM, 2V RT",2001117,CDM,73090,CPT,Facility,both,,,,285,142.5,,,,,,,,,,,,
GB SERIES,2001118,CDM,74290,CPT,Facility,both,,,,263,131.5,,,,,,,,,,,,
"HAND, MIN 3V RT",2001119,CDM,73130,CPT,Facility,both,,,,243,121.5,,,,,,,,,,,,
"HUMERUS, MIN 2V RT",2001122,CDM,73060,CPT,Facility,both,,,,281,140.5,,,,,,,,,,,,
STERNUM 2 VIEWS,2001123,CDM,71120,CPT,Facility,both,,,,281,140.5,,,,,,,,,,,,
BONE AGE,2001124,CDM,77072,CPT,Facility,both,,,,183,91.5,,,,,,,,,,,,
"KNEE, LMT 1-2 VIEWS RT",2001125,CDM,73560,CPT,Facility,both,,,,216,108,,,,,,,,,,,,
ACUTE ABD SERIES,2001126,CDM,74022,CPT,Facility,both,,,,714,357,,,,,,,,,,,,
"CYSTOGRAM, MIN 3V",2001127,CDM,74430,CPT,Facility,both,,,,340,170,,,,,,,,,,,,
"SINUSES (LMT), <3 VIEW",2001129,CDM,70210,CPT,Facility,both,,,,185,92.5,,,,,,,,,,,,
STERNOCL JOINTS Bilateral,2001130,CDM,71130,CPT,Facility,both,,,,263,131.5,,,,,,,,,,,,
FINGER RT 4TH DIGIT MIN 2 VIEW,2001132,CDM,73140,CPT,Facility,both,,,,242,121,,,,,,,,,,,,
TOE LT 2ND,2001134,CDM,73660,CPT,Facility,both,,,,229,114.5,,,,,,,,,,,,
TOE LT 4TH,2001136,CDM,73660,CPT,Facility,both,,,,229,114.5,,,,,,,,,,,,
"THUMB RT, MIN 2 VIEW",2001138,CDM,73140,CPT,Facility,both,,,,242,121,,,,,,,,,,,,
GREAT TOE RT,2001140,CDM,73660,CPT,Facility,both,,,,229,114.5,,,,,,,,,,,,
TOE RT 3RD,2001142,CDM,73660,CPT,Facility,both,,,,229,114.5,,,,,,,,,,,,
TOE RT 5TH,2001144,CDM,73660,CPT,Facility,both,,,,229,114.5,,,,,,,,,,,,
SPINE LUMBAR BE 2 OR 3,2001146,CDM,72120,CPT,Facility,both,,,,608,304,,,,,,,,,,,,
RIBS W/PA CHEST BIL,2001151,CDM,71111,CPT,Facility,both,,,,749,374.5,,,,,,,,,,,,
"ELBOW, 2 VIEWS RT",2001152,CDM,73070,CPT,Facility,both,,,,240,120,,,,,,,,,,,,
NECK (SOFT TISSUE),2001154,CDM,70360,CPT,Facility,both,,,,227,113.5,,,,,,,,,,,,
FB (CHILD) NOSE TO RECTUM,2001155,CDM,76010,CPT,Facility,both,,,,134,67,,,,,,,,,,,,
SINUS TRACT,2001156,CDM,76080,CPT,Facility,both,,,,295,147.5,,,,,,,,,,,,
RIBS W/PA CHEST RT,2001158,CDM,71101,CPT,Facility,both,,,,364,182,,,,,,,,,,,,
ESOPHAGUS,2001163,CDM,74220,CPT,Facility,both,,,,620,310,,,,,,,,,,,,
"HAND, 2 VIEWS LT",2001172,CDM,73120,CPT,Facility,both,,,,275,137.5,,,,,,,,,,,,
PLACE PORT-A-CATH W/FLURO,2001176,CDM,77001,CPT,Facility,both,,,,245,122.5,,,,,,,,,,,,
FLUORO GUIDE NEEDLE PLCMNT,2001179,CDM,77003,CPT,Facility,both,,,,1185,592.5,,,,,,,,,,,,
"HAND, 2 VIEWS RT",2001183,CDM,73120,CPT,Facility,both,,,,275,137.5,,,,,,,,,,,,
FLUORO IVC PLACEMENT,2001200,CDM,77001,CPT,Facility,both,,,,245,122.5,,,,,,,,,,,,
SPINE CERVICAL 1 VIEW,2001206,CDM,72020,CPT,Facility,both,,,,219,109.5,,,,,,,,,,,,
SPINE THORACIC 1 VIEW,2001207,CDM,72020,CPT,Facility,both,,,,219,109.5,,,,,,,,,,,,
HIP W/PELVIS BILAT 2 VIEWS,2001221,CDM,73521,CPT,Facility,both,,,,679,339.5,,,,,,,,,,,,
SPINE LUMBAR 1 VIEW,2001236,CDM,72020,CPT,Facility,both,,,,219,109.5,,,,,,,,,,,,
SPINE ENTIRE 1 VIEW,2001238,CDM,72081,CPT,Facility,both,,,,247.83,123.92,,,,,,,,,,,,
ORBITS FOR FB LOCATION,2001239,CDM,70030,CPT,Facility,both,,,,300,150,,,,,,,,,,,,
HIP W/PELVIS UNILA 1 VIEW LT,2001242,CDM,73501,CPT,Facility,both,,,,586,293,,,,,,,,,,,,
DEXA BONE DENSITY AXIAL,2001243,CDM,77080,CPT,Facility,both,,,,275,137.5,,,,,,,,,,,,
DEXA BONE DENSITY APPENDICULAR,2001244,CDM,77081,CPT,Facility,both,,,,226,113,,,,,,,,,,,,
HIP W/PELVIS UNILA 1 VIEW RT,2001246,CDM,73501,CPT,Facility,both,,,,586,293,,,,,,,,,,,,
FEMUR 1 VIEW LT,2001247,CDM,73551,CPT,Facility,both,,,,216,108,,,,,,,,,,,,
FEMUR 1 VIEW RT,2001248,CDM,73551,CPT,Facility,both,,,,216,108,,,,,,,,,,,,
BONE &/JOINT IMAG LMTD AREA,2001249,CDM,78300,CPT,Facility,both,,,,626,313,,,,,,,,,,,,
BONE &/JOINT IMAG MULT AREAS,2001250,CDM,78305,CPT,Facility,both,,,,1122,561,,,,,,,,,,,,
BONE &/JOINT IMAG WHOLE BODY,2001251,CDM,78306,CPT,Facility,both,,,,1684,842,,,,,,,,,,,,
BONE &/JOINT IMAGING 3PHASE,2001252,CDM,78315,CPT,Facility,both,,,,1427,713.5,,,,,,,,,,,,
RP LOCLZJ TUM PLNR 1 AREA SIN,2001253,CDM,78800,CPT,Facility,both,,,,2083,1041.5,,,,,,,,,,,,
RP LOCLZJ TUM PLNR 2+AREA,2001254,CDM,78801,CPT,Facility,both,,,,2083,1041.5,,,,,,,,,,,,
RP LOCLZJ TUM PLNR WHOLE BODY,2001255,CDM,78802,CPT,Facility,both,,,,1524,762,,,,,,,,,,,,
RP LOCLZJ TUM SPECT 1 AREA,2001256,CDM,78803,CPT,Facility,both,,,,2985,1492.5,,,,,,,,,,,,
RP LOCLZJ TUM SPECT W/CT,2001257,CDM,78830,CPT,Facility,both,,,,3014,1507,,,,,,,,,,,,
RP LOCLZJ TUM SPECT 2 AREA,2001258,CDM,78831,CPT,Facility,both,,,,3845,1922.5,,,,,,,,,,,,
RP LOCLZJ TUM SPECT CT 2AREA,2001259,CDM,78832,CPT,Facility,both,,,,5696,2848,,,,,,,,,,,,
Gastrografin 66-10 Solution,2005013,CDM,J2281,HCPCS,Facility,both,,,,6,3,,,,,,,,,,,,
Iodixanol 320 MG/ML 100,2005029,CDM,J2359,HCPCS,Facility,both,,,,4,2,,,,,,,,,,,,
IohexoL 350 MG/ML INFUS,2005030,CDM,J2360,HCPCS,Facility,both,,,,4,2,,,,,,,,,,,,
US CAR UNILT,2101001,CDM,93882,CPT,Facility,both,,,,658,329,,,,,,,,,,,,
US CAR UNIRT,2101002,CDM,93882,CPT,Facility,both,,,,658,329,,,,,,,,,,,,
US CAROTID DUPLEX BILAT,2101003,CDM,93880,CPT,Facility,both,,,,1316,658,,,,,,,,,,,,
US OB COM ADD GEST >14,2101012,CDM,76812,CPT,Facility,both,,,,763,381.5,,,,,,,,,,,,
US OB COMPLETE (>14WKS),2101013,CDM,76811,CPT,Facility,both,,,,555,277.5,,,,,,,,,,,,
US OB 1ST TRI (<14WKS),2101014,CDM,76801,CPT,Facility,both,,,,789,394.5,,,,,,,,,,,,
US OB 1ST TRI ADD GEST,2101015,CDM,76802,CPT,Facility,both,,,,789,394.5,,,,,,,,,,,,
US RETROPERITONEAL COMPLETE,2101018,CDM,76770,CPT,Facility,both,,,,371,185.5,,,,,,,,,,,,
"US ABD AORTA, LIMITED",2101020,CDM,76775,CPT,Facility,both,,,,315,157.5,,,,,,,,,,,,
US ABD COMPLETE,2101021,CDM,76700,CPT,Facility,both,,,,1088,544,,,,,,,,,,,,
US ABD-LMT(1QUAD/ORG,2101022,CDM,76705,CPT,Facility,both,,,,702,351,,,,,,,,,,,,
US BIO PROFILE,2101023,CDM,76818,CPT,Facility,both,,,,556,278,,,,,,,,,,,,
US CHEST,2101026,CDM,76604,CPT,Facility,both,,,,255,127.5,,,,,,,,,,,,
US GUIDED PARACENTESIS,2101030,CDM,76942,CPT,Facility,both,,,,551,275.5,,,,,,,,,,,,
US OB LMT,2101032,CDM,76815,CPT,Facility,both,,,,672,336,,,,,,,,,,,,
US PELVIS,2101033,CDM,76856,CPT,Facility,both,,,,1024,512,,,,,,,,,,,,
US SCROTUM,2101036,CDM,76870,CPT,Facility,both,,,,562,281,,,,,,,,,,,,
US THYROID,2101037,CDM,76536,CPT,Facility,both,,,,300,150,,,,,,,,,,,,
US OB FETAL > 14 WEEKS,2101051,CDM,76805,CPT,Facility,both,,,,762,381,,,,,,,,,,,,
US TRANSVAGINAL,2101055,CDM,76830,CPT,Facility,both,,,,954,477,,,,,,,,,,,,
US LTD PELVIS,2101056,CDM,76857,CPT,Facility,both,,,,611,305.5,,,,,,,,,,,,
US OB F/U,2101057,CDM,76816,CPT,Facility,both,,,,555,277.5,,,,,,,,,,,,
US 2 D ECHO,2101059,CDM,93307,CPT,Facility,both,,,,614,307,,,,,,,,,,,,
US COLOR FLOW,2101061,CDM,93325,CPT,Facility,both,,,,614,307,,,,,,,,,,,,
US DOPPLER,2101062,CDM,93320,CPT,Facility,both,,,,614,307,,,,,,,,,,,,
US ECHO W/DOPPLER/COLOR FLOW,2101063,CDM,93306,CPT,Facility,both,,,,2311,1155.5,,,,,,,,,,,,
US OB TRANSVAGINAL,2101070,CDM,76817,CPT,Facility,both,,,,819,409.5,,,,,,,,,,,,
US VENOUS DOPPLER UPPER EXT RT,2101076,CDM,93971,CPT,Facility,both,,,,667.14,333.57,,,,,,,,,,,,
US TRANSPLANT KIDNEY LT,2101082,CDM,76776,CPT,Facility,both,,,,610,305,,,,,,,,,,,,
US TRANSPLANT KIDNEY RT,2101083,CDM,76776,CPT,Facility,both,,,,610,305,,,,,,,,,,,,
US GALLBLADDER,2101084,CDM,76705,CPT,Facility,both,,,,287,143.5,,,,,,,,,,,,
US LIVER,2101085,CDM,76705,CPT,Facility,both,,,,287,143.5,,,,,,,,,,,,
ZZ US BREAST BILATERAL,2101088,CDM,76641,CPT,Facility,both,,,,276,138,,,,,,,,,,,,
US GUIDE VASCULAR ACCESS,2101089,CDM,76937,CPT,Facility,both,,,,778,389,,,,,,,,,,,,
US ABDOMINAL DOPPLER,2101090,CDM,93975,CPT,Facility,both,,,,1410,705,,,,,,,,,,,,
"US JOINT/NONVAS EXTRE, LD",2101092,CDM,76882,CPT,Facility,both,,,,150,75,,,,,,,,,,,,
US VENOUS DOPP LOW EXT LT,2101096,CDM,93971,CPT,Facility,both,,,,667.14,333.57,,,,,,,,,,,,
US VENOUS DOPP LOW EXT RT,2101097,CDM,93971,CPT,Facility,both,,,,667.14,333.57,,,,,,,,,,,,
US VENOUS DOP LOW EXT BIL,2101102,CDM,93970,CPT,Facility,both,,,,1410,705,,,,,,,,,,,,
"US JOINT/NONV EXTRE, LIMD LT",2101105,CDM,76882,CPT,Facility,both,,,,250,125,,,,,,,,,,,,
"US JOINT/NON EXTR, LIMD RT",2101106,CDM,76882,CPT,Facility,both,,,,250,125,,,,,,,,,,,,
US COMPLETE JOINT RT,2101111,CDM,76881,CPT,Facility,both,,,,435,217.5,,,,,,,,,,,,
US COMPLETE JOINT LT,2101112,CDM,76881,CPT,Facility,both,,,,435,217.5,,,,,,,,,,,,
DUPLEX SCAN OF HEMODI,2101116,CDM,93990,CPT,Facility,both,,,,6676.14,3338.07,,,,,,,,,,,,
"US DUPL,AO/IVC/LLIAC",2101118,CDM,93978,CPT,Facility,both,,,,1410,705,,,,,,,,,,,,
US BREAST COMPLETE RT,2101123,CDM,76641,CPT,Facility,both,,,,600,300,,,,,,,,,,,,
US BREAST COMPLETE LT,2101124,CDM,76641,CPT,Facility,both,,,,600,300,,,,,,,,,,,,
US BREAST LIMITED RT,2101125,CDM,76642,CPT,Facility,both,,,,522,261,,,,,,,,,,,,
US BREAST LIMITED LT,2101126,CDM,76642,CPT,Facility,both,,,,522,261,,,,,,,,,,,,
US ABD AOR ANEURYSM,2101127,CDM,76706,CPT,Facility,both,,,,923,461.5,,,,,,,,,,,,
US RETROPERI LTD,2101128,CDM,76775,CPT,Facility,both,,,,459,229.5,,,,,,,,,,,,
US VEN DOP UE BI,2101129,CDM,93970,CPT,Facility,both,,,,705,352.5,,,,,,,,,,,,
US VEN DOP UE LT,2101130,CDM,93971,CPT,Facility,both,,,,333.57,166.79,,,,,,,,,,,,
CT ABD ONLY W/C,2201001,CDM,74160,CPT,Facility,both,,,,2527,1263.5,,,,,,,,,,,,
CT ABD W/WO C,2201002,CDM,74170,CPT,Facility,both,,,,2703,1351.5,,,,,,,,,,,,
CT ABD ONLY W/O,2201003,CDM,74150,CPT,Facility,both,,,,2293,1146.5,,,,,,,,,,,,
CT ANGIO CHEST NON PE,2201004,CDM,71275,CPT,Facility,both,,,,2919,1459.5,,,,,,,,,,,,
CT SPINE CERV LMT,2201005,CDM,76380,CPT,Facility,both,,,,671,335.5,,,,,,,,,,,,
CT THORAX W/C,2201006,CDM,71260,CPT,Facility,both,,,,2586,1293,,,,,,,,,,,,
CT THORAX W/WO C,2201007,CDM,71270,CPT,Facility,both,,,,2703,1351.5,,,,,,,,,,,,
CT THORAX WO/C,2201008,CDM,71250,CPT,Facility,both,,,,2235,1117.5,,,,,,,,,,,,
CT FACIAL W/C,2201009,CDM,70487,CPT,Facility,both,,,,1650,825,,,,,,,,,,,,
CTA CHEST W/C,2201012,CDM,71275,CPT,Facility,both,,,,2919,1459.5,,,,,,,,,,,,
CT FACIAL BONES WO/C,2201013,CDM,70486,CPT,Facility,both,,,,1555,777.5,,,,,,,,,,,,
CT FACIAL W/WO C,2201014,CDM,70488,CPT,Facility,both,,,,1737,868.5,,,,,,,,,,,,
CT ORBIT/EAR/FOSSA WO/C,2201016,CDM,70480,CPT,Facility,both,,,,1417,708.5,,,,,,,,,,,,
CT HEAD W/C,2201017,CDM,70460,CPT,Facility,both,,,,2165,1082.5,,,,,,,,,,,,
CT HEAD W/WO C,2201018,CDM,70470,CPT,Facility,both,,,,2194,1097,,,,,,,,,,,,
CT HEAD WO/C,2201019,CDM,70450,CPT,Facility,both,,,,2106,1053,,,,,,,,,,,,
CT LMT STUDY/LOC FUN STDY,2201020,CDM,76380,CPT,Facility,both,,,,671,335.5,,,,,,,,,,,,
CT SOFT TISS NECK W/C,2201023,CDM,70491,CPT,Facility,both,,,,2340,1170,,,,,,,,,,,,
CT SOFT TISS NECK W/WO C,2201024,CDM,70492,CPT,Facility,both,,,,2399,1199.5,,,,,,,,,,,,
CT SOFT TISS NECK WO/C,2201025,CDM,70490,CPT,Facility,both,,,,1755,877.5,,,,,,,,,,,,
CT PELVIS W/C,2201028,CDM,72193,CPT,Facility,both,,,,2761,1380.5,,,,,,,,,,,,
CT PELVIS W/WO C,2201029,CDM,72194,CPT,Facility,both,,,,2831,1415.5,,,,,,,,,,,,
CT PELVIS WO/C,2201030,CDM,72192,CPT,Facility,both,,,,2293,1146.5,,,,,,,,,,,,
CT SINUSES LMT,2201031,CDM,76380,CPT,Facility,both,,,,671,335.5,,,,,,,,,,,,
CT SINUSES COMP W/WO C,2201032,CDM,70488,CPT,Facility,both,,,,1737,868.5,,,,,,,,,,,,
CT SINUSES WO/C,2201033,CDM,70486,CPT,Facility,both,,,,1555,777.5,,,,,,,,,,,,
CT SPINE THOR WO/C,2201034,CDM,72128,CPT,Facility,both,,,,1526,763,,,,,,,,,,,,
CT SPINE CERV WO/C,2201035,CDM,72125,CPT,Facility,both,,,,2462,1231,,,,,,,,,,,,
CT SPINE LUMBAR W/C,2201036,CDM,72132,CPT,Facility,both,,,,1989,994.5,,,,,,,,,,,,
CT SPINE LUMBAR WO/C,2201037,CDM,72131,CPT,Facility,both,,,,1989,994.5,,,,,,,,,,,,
CT UPPER EXT RT WO/C,2201038,CDM,73200,CPT,Facility,both,,,,1381,690.5,,,,,,,,,,,,
CT UPPER EXTLT WO/C,2201039,CDM,73200,CPT,Facility,both,,,,1381,690.5,,,,,,,,,,,,
CT Upper Extremity W CONTRAST,2201040,CDM,73201,CPT,Facility,both,,,,1454,727,,,,,,,,,,,,
CT ANGIO HEAD,2201041,CDM,70496,CPT,Facility,both,,,,2919,1459.5,,,,,,,,,,,,
CT ANGIO NECK,2201042,CDM,70498,CPT,Facility,both,,,,2503,1251.5,,,,,,,,,,,,
CT LOWER EXT W/C LT,2201043,CDM,73701,CPT,Facility,both,,,,1767,883.5,,,,,,,,,,,,
CT LOWER EXT W/C RT,2201044,CDM,73701,CPT,Facility,both,,,,1767,883.5,,,,,,,,,,,,
CTA ABD W/C,2201046,CDM,74175,CPT,Facility,both,,,,2919,1459.5,,,,,,,,,,,,
CT ANGIO RENAL ARTERY,2201047,CDM,74175,CPT,Facility,both,,,,2919,1459.5,,,,,,,,,,,,
CT ELBOW RT W CON,2201048,CDM,73201,CPT,Facility,both,,,,154,77,,,,,,,,,,,,
CT ELBOW RT WO CON,2201049,CDM,73200,CPT,Facility,both,,,,1381,690.5,,,,,,,,,,,,
CT ELBOW RT WO/W CON,2201050,CDM,73202,CPT,Facility,both,,,,1678,839,,,,,,,,,,,,
CT LWR EXT W/WO C LT,2201051,CDM,73702,CPT,Facility,both,,,,3534,1767,,,,,,,,,,,,
CT LWR EXT W/WO C RT,2201052,CDM,73702,CPT,Facility,both,,,,3534,1767,,,,,,,,,,,,
CT LWR EXT WO LT,2201056,CDM,73700,CPT,Facility,both,,,,1533,766.5,,,,,,,,,,,,
CT LWR EXT WO/C RT,2201079,CDM,73700,CPT,Facility,both,,,,1533,766.5,,,,,,,,,,,,
CTA PELVIS W/C,2201086,CDM,72191,CPT,Facility,both,,,,2919,1459.5,,,,,,,,,,,,
CT ABD PELV W/WO C,2201088,CDM,74178,CPT,Facility,both,,,,5616,2808,,,,,,,,,,,,
CT ABD PELV W/C,2201089,CDM,74177,CPT,Facility,both,,,,5148,2574,,,,,,,,,,,,
CT ABD PELV W/O C,2201090,CDM,74176,CPT,Facility,both,,,,4680,2340,,,,,,,,,,,,
CTA ABD PELV W/WO C,2201094,CDM,74174,CPT,Facility,both,,,,5587,2793.5,,,,,,,,,,,,
CT ANG AORTA,2201095,CDM,75635,CPT,Facility,both,,,,2246,1123,,,,,,,,,,,,
CT ANGIO UE LT,2201096,CDM,73206,CPT,Facility,both,,,,2491,1245.5,,,,,,,,,,,,
CT ANGIO UE RT,2201097,CDM,73206,CPT,Facility,both,,,,2491,1245.5,,,,,,,,,,,,
CT ANKLE LT W CON,2201098,CDM,73701,CPT,Facility,both,,,,1767,883.5,,,,,,,,,,,,
CT ANKLE LT WO CON,2201099,CDM,73700,CPT,Facility,both,,,,1533,766.5,,,,,,,,,,,,
CT ANKLE LT WO/W CON,2201100,CDM,73702,CPT,Facility,both,,,,3534,1767,,,,,,,,,,,,
CT ANKLE RT W CON,2201101,CDM,73701,CPT,Facility,both,,,,1767,883.5,,,,,,,,,,,,
CT ANKLE RT WO CON,2201102,CDM,73700,CPT,Facility,both,,,,1533,766.5,,,,,,,,,,,,
CT ANKLE RT WO/W CON,2201103,CDM,73702,CPT,Facility,both,,,,3534,1767,,,,,,,,,,,,
CT BONY PELVIS,2201104,CDM,72192,CPT,Facility,both,,,,2293,1146.5,,,,,,,,,,,,
CT CALCANEUS LT,2201105,CDM,73700,CPT,Facility,both,,,,1533,766.5,,,,,,,,,,,,
CT CALCANEUS RT,2201106,CDM,73700,CPT,Facility,both,,,,1533,766.5,,,,,,,,,,,,
CT FOREARM LT W CON,2201107,CDM,73201,CPT,Facility,both,,,,1454,727,,,,,,,,,,,,
CT FOREARM LT WO CON,2201108,CDM,73200,CPT,Facility,both,,,,1381,690.5,,,,,,,,,,,,
CT FOREARM LT WO/W CON,2201109,CDM,73202,CPT,Facility,both,,,,1678,839,,,,,,,,,,,,
CT FOREARM RT W CON,2201110,CDM,73201,CPT,Facility,both,,,,1454,727,,,,,,,,,,,,
CT FOREARM RT WO CON,2201111,CDM,73200,CPT,Facility,both,,,,1381,690.5,,,,,,,,,,,,
CT FOREARM RT WO/W CON,2201112,CDM,73202,CPT,Facility,both,,,,1678,839,,,,,,,,,,,,
CT FEMUR LT W CON,2201113,CDM,73701,CPT,Facility,both,,,,1767,883.5,,,,,,,,,,,,
CT FEMUR LT WO CON,2201114,CDM,73700,CPT,Facility,both,,,,1533,766.5,,,,,,,,,,,,
CT FEMUR LT WO/W CON,2201115,CDM,73702,CPT,Facility,both,,,,3534,1767,,,,,,,,,,,,
CT FEMUR RT W CON,2201116,CDM,73701,CPT,Facility,both,,,,1767,883.5,,,,,,,,,,,,
CT FEMUR RT WO CON,2201117,CDM,73700,CPT,Facility,both,,,,1533,766.5,,,,,,,,,,,,
CT FEMUR RT WO/W CON,2201118,CDM,73702,CPT,Facility,both,,,,3534,1767,,,,,,,,,,,,
CT FOOT LT W CON,2201119,CDM,73701,CPT,Facility,both,,,,1767,883.5,,,,,,,,,,,,
CT FOOT LT WO CON,2201120,CDM,73700,CPT,Facility,both,,,,1533,766.5,,,,,,,,,,,,
CT FOOT LT WO/W CON,2201121,CDM,73702,CPT,Facility,both,,,,3534,1767,,,,,,,,,,,,
CT FOOT RT W CON,2201122,CDM,73701,CPT,Facility,both,,,,1767,883.5,,,,,,,,,,,,
CT FOOT RT WO CON,2201123,CDM,73700,CPT,Facility,both,,,,1533,766.5,,,,,,,,,,,,
CT FOOT RT WO/W CON,2201124,CDM,73702,CPT,Facility,both,,,,3534,1767,,,,,,,,,,,,
CT HAND LT W CON,2201125,CDM,73201,CPT,Facility,both,,,,1454,727,,,,,,,,,,,,
CT HAND LT WO CON,2201126,CDM,73200,CPT,Facility,both,,,,1381,690.5,,,,,,,,,,,,
CT HAND LT WO/W CON,2201127,CDM,73202,CPT,Facility,both,,,,1678,839,,,,,,,,,,,,
CT HAND RT W CON,2201128,CDM,73201,CPT,Facility,both,,,,1454,727,,,,,,,,,,,,
CT HAND RT WO CON,2201129,CDM,73200,CPT,Facility,both,,,,1381,690.5,,,,,,,,,,,,
CT HAND RT WO/W CON,2201130,CDM,73202,CPT,Facility,both,,,,1678,839,,,,,,,,,,,,
CT HEART W CAL,2201131,CDM,75571,CPT,Facility,both,,,,299,149.5,,,,,,,,,,,,
CT HIP LT W CON,2201132,CDM,73701,CPT,Facility,both,,,,1767,883.5,,,,,,,,,,,,
CT HIP LT WO CON,2201133,CDM,73700,CPT,Facility,both,,,,1533,766.5,,,,,,,,,,,,
CT HIP LT WO/W CON,2201134,CDM,73702,CPT,Facility,both,,,,3534,1767,,,,,,,,,,,,
CT HIP RT W CON,2201135,CDM,73701,CPT,Facility,both,,,,1767,883.5,,,,,,,,,,,,
CT HIP RT WO CON,2201136,CDM,73700,CPT,Facility,both,,,,1533,766.5,,,,,,,,,,,,
CT HIP RT WO/W CON,2201137,CDM,73702,CPT,Facility,both,,,,3534,1767,,,,,,,,,,,,
CT HUMERUS LT W CON,2201138,CDM,73201,CPT,Facility,both,,,,1454,727,,,,,,,,,,,,
CT HUMERUS LT WO CON,2201139,CDM,73200,CPT,Facility,both,,,,1381,690.5,,,,,,,,,,,,
CT HUMERUS LT WO/W CON,2201140,CDM,73202,CPT,Facility,both,,,,1678,839,,,,,,,,,,,,
CT HUMERUS RT W CON,2201141,CDM,73201,CPT,Facility,both,,,,1454,727,,,,,,,,,,,,
CT HUMERUS RT WO CON,2201142,CDM,73200,CPT,Facility,both,,,,1381,690.5,,,,,,,,,,,,
CT HUMERUS RT WO/W CON,2201143,CDM,73202,CPT,Facility,both,,,,1678,839,,,,,,,,,,,,
CT KNEE LT W CON,2201144,CDM,73701,CPT,Facility,both,,,,1767,883.5,,,,,,,,,,,,
CT KNEE LT WO CON,2201145,CDM,73700,CPT,Facility,both,,,,1533,766.5,,,,,,,,,,,,
CT KNEE LT WO/W CON,2201146,CDM,73702,CPT,Facility,both,,,,3534,1767,,,,,,,,,,,,
CT KNEE RT W CON,2201147,CDM,73701,CPT,Facility,both,,,,1767,883.5,,,,,,,,,,,,
CT KNEE RT WO CON,2201148,CDM,73700,CPT,Facility,both,,,,1533,766.5,,,,,,,,,,,,
CT KNEE RT WO/W CON,2201149,CDM,73702,CPT,Facility,both,,,,3534,1767,,,,,,,,,,,,
CT LOW LEG LT W CON,2201150,CDM,73701,CPT,Facility,both,,,,1767,883.5,,,,,,,,,,,,
CT LOW LEG LT WO CON,2201151,CDM,73700,CPT,Facility,both,,,,1533,766.5,,,,,,,,,,,,
CT LOW LEG LT WO/W CON,2201152,CDM,73702,CPT,Facility,both,,,,3534,1767,,,,,,,,,,,,
CT LOW LEG RT W CON,2201153,CDM,73701,CPT,Facility,both,,,,1767,883.5,,,,,,,,,,,,
CT LOW LEG RT WO CON,2201154,CDM,73700,CPT,Facility,both,,,,1533,766.5,,,,,,,,,,,,
CT LOW LEG RT WO/W CON,2201155,CDM,73702,CPT,Facility,both,,,,3534,1767,,,,,,,,,,,,
CT LUNG SCREEN,2201156,CDM,71275,CPT,Facility,both,,,,293,146.5,,,,,,,,,,,,
CT PANCREAS 3PHASE,2201157,CDM,74170,CPT,Facility,both,,,,2919,1459.5,,,,,,,,,,,,
CT SCAPULA LT,2201158,CDM,73200,CPT,Facility,both,,,,1381,690.5,,,,,,,,,,,,
CT SCAPULA RT,2201159,CDM,73200,CPT,Facility,both,,,,1381,690.5,,,,,,,,,,,,
CT SHOULDER LT W CON,2201160,CDM,73201,CPT,Facility,both,,,,1454,727,,,,,,,,,,,,
CT SHOULDER LT WO CON,2201161,CDM,73200,CPT,Facility,both,,,,1381,690.5,,,,,,,,,,,,
CT SHOULDER LT WO/W CON,2201162,CDM,73202,CPT,Facility,both,,,,1678,839,,,,,,,,,,,,
CT SHOULDER RT W CON,2201163,CDM,73201,CPT,Facility,both,,,,1454,727,,,,,,,,,,,,
CT SHOULDER RT WO CON,2201164,CDM,73200,CPT,Facility,both,,,,1381,690.5,,,,,,,,,,,,
CT SHOULDER RT WO/W CON,2201165,CDM,73202,CPT,Facility,both,,,,1678,839,,,,,,,,,,,,
CT WRIST LT W CON,2201166,CDM,73201,CPT,Facility,both,,,,1454,727,,,,,,,,,,,,
CT WRIST LT WO CON,2201167,CDM,73200,CPT,Facility,both,,,,1381,690.5,,,,,,,,,,,,
CT WRIST LT WO/W CON,2201168,CDM,73202,CPT,Facility,both,,,,1678,839,,,,,,,,,,,,
CT WRIST RT W CON,2201169,CDM,73201,CPT,Facility,both,,,,1454,727,,,,,,,,,,,,
CT WRIST RT WO CON,2201170,CDM,73200,CPT,Facility,both,,,,1381,690.5,,,,,,,,,,,,
CT WRIST RT WO/W CON,2201171,CDM,73202,CPT,Facility,both,,,,1678,839,,,,,,,,,,,,
MR ABD W/O,2301004,CDM,74181,CPT,Facility,both,,,,219,109.5,,,,,,,,,,,,
MR BONE MARROW,2301005,CDM,77084,CPT,Facility,both,,,,2134,1067,,,,,,,,,,,,
MRI BREAST W/O CONT,2301011,CDM,77046,CPT,Facility,both,,,,1599,799.5,,,,,,,,,,,,
MR CHEST W/O,2301019,CDM,71550,CPT,Facility,both,,,,219,109.5,,,,,,,,,,,,
MR C-SPINE W/O,2301020,CDM,72141,CPT,Facility,both,,,,281,140.5,,,,,,,,,,,,
MR FACE/NECK W/O,2301021,CDM,70540,CPT,Facility,both,,,,445,222.5,,,,,,,,,,,,
MR PELVIS W/C,2301035,CDM,72196,CPT,Facility,both,,,,281,140.5,,,,,,,,,,,,
MR PELVIS W/O,2301036,CDM,72195,CPT,Facility,both,,,,229,114.5,,,,,,,,,,,,
MR T-SPINE W/C,2301038,CDM,72147,CPT,Facility,both,,,,2919,1459.5,,,,,,,,,,,,
MR ABD W/C,2301056,CDM,74182,CPT,Facility,both,,,,2366,1183,,,,,,,,,,,,
MR ABD W/WO,2301057,CDM,74183,CPT,Facility,both,,,,3031,1515.5,,,,,,,,,,,,
MR FACE/NECK W/C,2301058,CDM,70542,CPT,Facility,both,,,,509,254.5,,,,,,,,,,,,
MR T-SPINE W/O,2301065,CDM,72146,CPT,Facility,both,,,,293,146.5,,,,,,,,,,,,
MR CHEST W/WO,2301066,CDM,71552,CPT,Facility,both,,,,219,109.5,,,,,,,,,,,,
Rho(d) Imm Glbln F-D Im 90384,2388322,CDM,90384,CPT,Facility,both,,,,620,310,,,,,,,,,,,,
Psych Complex Interactv 90785,2388416,CDM,90785,CPT,Facility,both,,,,58.36,29.18,,,,,,,,,,,,
Psychiatric Dx Eval 90791,2388417,CDM,90791,CPT,Facility,both,,,,241,120.5,,,,,,,,,,,,
Psych Dx Eval w/Med Serv 90792,2388418,CDM,90792,CPT,Facility,both,,,,320,160,,,,,,,,,,,,
Psych w/Patient 30 min 90832,2388420,CDM,90832,CPT,Facility,both,,,,120,60,,,,,,,,,,,,
Family Psych w/o Patient 90846,2388429,CDM,90846,CPT,Facility,both,,,,387.4,193.7,,,,,,,,,,,,
Family Psych w/Patient  908477,2388430,CDM,90847,CPT,Facility,both,,,,319,159.5,,,,,,,,,,,,
Otolaryngologic Exm GnAn 92502,2388558,CDM,92502,CPT,Facility,both,,,,370.64,185.32,,,,,,,,,,,,
Nebulizer Tx 94640,2388866,CDM,94640,CPT,Facility,outpatient,,,,122,61,,,,,,,,,,,,
ICUT ALLER TEST DRUG/BUG 95024,2388899,CDM,95024,CPT,Facility,both,,,,227.4,113.7,,,,,,,,,,,,
ICUT ALLERGY TITR-AIRBN 95027,2388900,CDM,95027,CPT,Facility,both,,,,100.92,50.46,,,,,,,,,,,,
IMMUNOTHERAPY 1 INJECTN 95115,2388910,CDM,95115,CPT,Facility,both,,,,35.8,17.9,,,,,,,,,,,,
IMMUNOTHERP MULT INJCTN 95117,2388911,CDM,95117,CPT,Facility,both,,,,43.52,21.76,,,,,,,,,,,,
Develop Scrn w/I&R 96110,2389039,CDM,96110,CPT,Facility,both,,,,137,68.5,,,,,,,,,,,,
Debrd Selctv EaAd 20sqcm 97598,2389140,CDM,97598,CPT,Facility,both,,,,297,148.5,,,,,,,,,,,,
Anesth Extrm Age Patient 99100,2389193,CDM,99100,CPT,Facility,both,,,,388,194,,,,,,,,,,,,
Visual Acuity Scrn QntBi 99173,2389205,CDM,99173,CPT,Facility,both,,,,43,21.5,,,,,,,,,,,,
Infs IV Hydration Add Hr 96361,2389273,CDM,96361,CPT,Facility,both,,,,293,146.5,,,,,,,,,,,,
Debride Selctv1st 20sqcm 97597,2389275,CDM,97597,CPT,Facility,both,,,,297,148.5,,,,,,,,,,,,
Inj Carpal Tunnel Ther 20526,2389279,CDM,20526,CPT,Facility,inpatient,,,,231,115.5,,,,,,,,,,,,
Inj Trg Pt S/ml >=3 Musc 20553,2389283,CDM,20553,CPT,Facility,both,,,,250,125,,,,,,,,,,,,
Arthrocent Asp/Inj Sml J 20600,2389284,CDM,20600,CPT,Facility,both,,,,625,312.5,,,,,,,,,,,,
Asp/inj Joint Med w/o US 20605,2389285,CDM,20605,CPT,Facility,both,,,,180,90,,,,,,,,,,,,
Asp/Inj GanglionCyst Any 20612,2389287,CDM,20612,CPT,Facility,both,,,,2238,1119,,,,,,,,,,,,
OBSERV CARE DSCH MGT 99217,2389421,CDM,99217,CPT,Facility,both,,,,325,162.5,,,,,,,,,,,,
INIT OBSERV CR/DAY 30 M 99218,2389422,CDM,99218,CPT,Facility,both,,,,379.99,190,,,,,,,,,,,,
INIT OBSERV CR/DAY 50 M 99219,2389423,CDM,99219,CPT,Facility,both,,,,514.88,257.44,,,,,,,,,,,,
INIT OBSERV CR/DAY 70 M 99220,2389424,CDM,99220,CPT,Facility,both,,,,695.84,347.92,,,,,,,,,,,,
INIT HOSP CARE/DAY 30 M 99221,2389425,CDM,99221,CPT,Facility,both,,,,389.8,194.9,,,,,,,,,,,,
INIT HOSP CARE/DAY 50 M 99222,2389426,CDM,99222,CPT,Facility,both,,,,524.96,262.48,,,,,,,,,,,,
INIT HOSP CARE/DAY 70 M 99223,2389427,CDM,99223,CPT,Facility,both,,,,770.16,385.08,,,,,,,,,,,,
SB OBSV CARE/DAY 15 MIN 99224,2389428,CDM,99224,CPT,Facility,both,,,,151.68,75.84,,,,,,,,,,,,
SB OBSV CARE/DAY 25 MIN 99225,2389429,CDM,99225,CPT,Facility,both,,,,275.68,137.84,,,,,,,,,,,,
SB OBSV CARE/DAY 35 MIN 99226,2389430,CDM,99226,CPT,Facility,both,,,,393.24,196.62,,,,,,,,,,,,
SB IP CARE/DAY 15 MIN 99231,2389431,CDM,99231,CPT,Facility,both,,,,150.4,75.2,,,,,,,,,,,,
SB IP CARE/DAY 25 MIN 99232,2389432,CDM,99232,CPT,Facility,both,,,,276.96,138.48,,,,,,,,,,,,
SB IP CARE/DAY 35 MIN 99233,2389433,CDM,99233,CPT,Facility,both,,,,398.04,199.02,,,,,,,,,,,,
OBSV/IP SAMEDAY CARE 40M 99234,2389434,CDM,99234,CPT,Facility,both,,,,506.48,253.24,,,,,,,,,,,,
OBSV/IP SAMEDAY CARE 50M 99235,2389435,CDM,99235,CPT,Facility,both,,,,642.72,321.36,,,,,,,,,,,,
OBSV/IP SAMEDAY CARE 55M 99236,2389436,CDM,99236,CPT,Facility,both,,,,823.36,411.68,,,,,,,,,,,,
HSPTL DSCH MGT 30 MIN/<  99238,2389437,CDM,99238,CPT,Facility,both,,,,278.6,139.3,,,,,,,,,,,,
HSPTL DISCH MGT > 30 MIN 99239,2389438,CDM,99239,CPT,Facility,both,,,,407.64,203.82,,,,,,,,,,,,
EMERG DEPT VISIT LIM/MIN 99281,2389449,CDM,99281,CPT,Facility,both,,,,86.24,43.12,,,,,,,,,,,,
EMERG DEPT VIS LOW/MOD 99282,2389450,CDM,99282,CPT,Facility,both,,,,167.04,83.52,,,,,,,,,,,,
EMERGENCY DEPT VISIT MOD 99283,2389451,CDM,99283,CPT,Facility,both,,,,284.28,142.14,,,,,,,,,,,,
EMERG DEPT VISIT HI/URG 99284,2389452,CDM,99284,CPT,Facility,both,,,,480.4,240.2,,,,,,,,,,,,
EMERG DEPT VIS HIGH SEVR 99285,2389453,CDM,99285,CPT,Facility,both,,,,697.64,348.82,,,,,,,,,,,,
SB NRS FAC/DAY E/M 10 M 99307,2389460,CDM,99307,CPT,Facility,both,,,,168.68,84.34,,,,,,,,,,,,
SB NRS FAC/DAY E/M 15 M 99308,2389461,CDM,99308,CPT,Facility,both,,,,265.84,132.92,,,,,,,,,,,,
SB NRS FAC/DAY E/M 25 M 99309,2389462,CDM,99309,CPT,Facility,both,,,,350.48,175.24,,,,,,,,,,,,
SB NRS FAC/DAY E/M 35 M 99310,2389463,CDM,99310,CPT,Facility,both,,,,517.16,258.58,,,,,,,,,,,,
NURS FAC DSCH MGT 30 M 99315,2389464,CDM,99315,CPT,Facility,both,,,,279.88,139.94,,,,,,,,,,,,
NURS FAC DSCH MGT >30 M 99316,2389465,CDM,99316,CPT,Facility,both,,,,401.36,200.68,,,,,,,,,,,,
BEHAV CHNG SMOKING 3-10 MIN,2389522,CDM,99406,CPT,Facility,both,,,,107.39,53.7,,,,,,,,,,,,
BEHAV CHNG SMOKING > 10 MIN,2389523,CDM,99407,CPT,Facility,both,,,,107.36,53.68,,,,,,,,,,,,
MAM UNILATERAL RT W/CAD,2401009,CDM,77065,CPT,Facility,both,,,,297,148.5,,,,,,,,,,,,
MAM UNILATERAL LT W/CAD,2401010,CDM,77065,CPT,Facility,both,,,,297,148.5,,,,,,,,,,,,
MAM BILATERAL DX W/CAD,2401011,CDM,77066,CPT,Facility,both,,,,585,292.5,,,,,,,,,,,,
MAM SCRN BILA EA/ W/CAD,2401012,CDM,77067,CPT,Facility,both,,,,530,265,,,,,,,,,,,,
MAM DIGITAL SCR RT W/CAD,2401019,CDM,77067,CPT,Facility,both,,,,530,265,,,,,,,,,,,,
MAM DIGITAL SCR LT W/CAD,2401020,CDM,77067,CPT,Facility,both,,,,530,265,,,,,,,,,,,,
MAM SCR DIG 3D UNILATERAL LT,2401023,CDM,77067,CPT,Facility,both,,,,530,265,,,,,,,,,,,,
MAM SCR DIG 3D UNILATERAL RT,2401024,CDM,77067,CPT,Facility,both,,,,530,265,,,,,,,,,,,,
MAM DIAG DIGITAL BILATERAL,2401025,CDM,77066,CPT,Facility,both,,,,585,292.5,,,,,,,,,,,,
MAM DIAG DIGITAL W/ TOMO,2401026,CDM,77063,CPT,Facility,both,,,,585,292.5,,,,,,,,,,,,
MAM DIAG DIGITAL UNILATERAL LT,2401027,CDM,77065,CPT,Facility,both,,,,297,148.5,,,,,,,,,,,,
MAM DIAG DIGITAL UNILATERAL RT,2401028,CDM,77065,CPT,Facility,both,,,,297,148.5,,,,,,,,,,,,
MAM SCR DIG 3D BILATERAL,2401031,CDM,77063,CPT,Facility,both,,,,494,247,,,,,,,,,,,,
MM SCREEN 2D BILATERAL,2401032,CDM,77067,CPT,Facility,both,,,,530,265,,,,,,,,,,,,
MM SCREEN 3D,2401033,CDM,77063,CPT,Facility,both,,,,375,187.5,,,,,,,,,,,,
MM ADD 3D,2401034,CDM,77062,CPT,Facility,both,,,,375,187.5,,,,,,,,,,,,
FNA bx w/o image 1st les 10021,2726314,CDM,10021,CPT,Facility,outpatient,,,,396.4,198.2,,,,,,,,,,,,
Drain Skin Abscess Smp/1 10060,2726317,CDM,10060,CPT,Facility,outpatient,,,,406,203,,,,,,,,,,,,
Debr&Rem Forgn Mat fx/dx 11010,2726322,CDM,11010,CPT,Facility,both,,,,1434,717,,,,,,,,,,,,
Debride Skin/musc/bn Fx 11012,2726323,CDM,11012,CPT,Facility,outpatient,,,,3180,1590,,,,,,,,,,,,
Debrd Musc/fasc <=20sqcm 11043,2726327,CDM,11043,CPT,Facility,outpatient,,,,1711,855.5,,,,,,,,,,,,
Debrid Tis SC Ea ad 20sq 11045,2726329,CDM,11045,CPT,Facility,outpatient,,,,736,368,,,,,,,,,,,,
Debrd Msc/fsc Ea ad 20sq11046,2726330,CDM,11046,CPT,Facility,outpatient,,,,907,453.5,,,,,,,,,,,,
Trim Skin Lesions 2-4 11056,2726332,CDM,11056,CPT,Facility,outpatient,,,,143,71.5,,,,,,,,,,,,
Trim Skin Lesions Over 4 11057,2726333,CDM,11057,CPT,Facility,outpatient,,,,161,80.5,,,,,,,,,,,,
ShvLsn F/e/e/n/l/m<=0.5cm11310,2726344,CDM,11310,CPT,Facility,outpatient,,,,222,111,,,,,,,,,,,,
ShvLsn F/e/e/n/l/m .6-1. 11311,2726345,CDM,11311,CPT,Facility,outpatient,,,,340,170,,,,,,,,,,,,
Exc Bgn Lesion w/Margins 11400,2726346,CDM,11400,CPT,Facility,outpatient,,,,365,182.5,,,,,,,,,,,,
Exc Bgn Lesion w/Margins 11401,2726347,CDM,11401,CPT,Facility,outpatient,,,,886,443,,,,,,,,,,,,
Exc Bgn Lesion w/Margins 11402,2726348,CDM,11402,CPT,Facility,outpatient,,,,886,443,,,,,,,,,,,,
Exc Bgn Lesion w/Margins 11403,2726349,CDM,11403,CPT,Facility,outpatient,,,,886,443,,,,,,,,,,,,
Exc Bgn Lesion w/Margins 11404,2726350,CDM,11404,CPT,Facility,outpatient,,,,2366,1183,,,,,,,,,,,,
Exc Bgn Lesion w/Margins 11406,2726351,CDM,11406,CPT,Facility,outpatient,,,,981,490.5,,,,,,,,,,,,
Exc Bgn Lesion w/Margins 11420,2726352,CDM,11420,CPT,Facility,outpatient,,,,1657,828.5,,,,,,,,,,,,
Exc Bgn Lesion w/Margins 11421,2726353,CDM,11421,CPT,Facility,outpatient,,,,465,232.5,,,,,,,,,,,,
Exc Bgn Lesion w/Margins 11422,2726354,CDM,11422,CPT,Facility,outpatient,,,,2366,1183,,,,,,,,,,,,
Exc Bgn Lesion w/Margins 11423,2726355,CDM,11423,CPT,Facility,outpatient,,,,1342,671,,,,,,,,,,,,
Exc Bgn Lesion w/Margins 11440,2726356,CDM,11440,CPT,Facility,outpatient,,,,886,443,,,,,,,,,,,,
Exc Bgn Lesion w/Margins 11441,2726357,CDM,11441,CPT,Facility,outpatient,,,,1475,737.5,,,,,,,,,,,,
Exc Bgn Lesion w/Margins 11442,2726358,CDM,11442,CPT,Facility,outpatient,,,,1623,811.5,,,,,,,,,,,,
Exc Mal Lesion w/ Margin 11602,2726359,CDM,11602,CPT,Facility,outpatient,,,,594,297,,,,,,,,,,,,
Exc Mal Lesion w/ Margin 11603,2726360,CDM,11603,CPT,Facility,outpatient,,,,681,340.5,,,,,,,,,,,,
Exc Mal Lesion w/ Margin 11604,2726361,CDM,11604,CPT,Facility,outpatient,,,,659,329.5,,,,,,,,,,,,
Exc Mal Lesion w/ Margin 11622,2726362,CDM,11622,CPT,Facility,outpatient,,,,511,255.5,,,,,,,,,,,,
Exc Mal Lesion w/ Margin 11623,2726363,CDM,11623,CPT,Facility,outpatient,,,,582,291,,,,,,,,,,,,
Exc Mal Lesion w/ Margin 11641,2726364,CDM,11641,CPT,Facility,outpatient,,,,570,285,,,,,,,,,,,,
Exc Mal Lesion w/ Margin 11642,2726365,CDM,11642,CPT,Facility,outpatient,,,,529,264.5,,,,,,,,,,,,
Exc Mal Lesion w/ Margin 11643,2726366,CDM,11643,CPT,Facility,outpatient,,,,622,311,,,,,,,,,,,,
Trim Nail(S) 11719,2726367,CDM,11719,CPT,Facility,outpatient,,,,50,25,,,,,,,,,,,,
Debride Nail < = 5 Nails 11720,2726368,CDM,11720,CPT,Facility,outpatient,,,,122,61,,,,,,,,,,,,
Debride Nail 6+ 11721,2726369,CDM,11721,CPT,Facility,outpatient,,,,120,60,,,,,,,,,,,,
Repair Nail Bed 11760,2726374,CDM,11760,CPT,Facility,outpatient,,,,1003,501.5,,,,,,,,,,,,
Wedge Exc Skn NlFld/IngT 11765,2726375,CDM,11765,CPT,Facility,outpatient,,,,403,201.5,,,,,,,,,,,,
Insert Drug Implant Dev 11981,2726381,CDM,11981,CPT,Facility,outpatient,,,,403,201.5,,,,,,,,,,,,
Remove Drug Implant Dev 11982,2726382,CDM,11982,CPT,Facility,outpatient,,,,419,209.5,,,,,,,,,,,,
Cplx Rep Trunk 2.6-7.5cm 13101,2726395,CDM,13101,CPT,Facility,outpatient,,,,951,475.5,,,,,,,,,,,,
CpxRp Trunk Ea Add<=5cm 13102,2726396,CDM,13102,CPT,Facility,outpatient,,,,245,122.5,,,,,,,,,,,,
CpxRp S/a/l 2.6-7.5cm 13121,2726397,CDM,13121,CPT,Facility,outpatient,,,,1028,514,,,,,,,,,,,,
CpxRp S/a/l EaAd <=5cm 13122,2726398,CDM,13122,CPT,Facility,outpatient,,,,336,168,,,,,,,,,,,,
CpxRp F/ch/c/m/N/a/g/h/f 13132,2726400,CDM,13132,CPT,Facility,outpatient,,,,1148,574,,,,,,,,,,,,
CpxRp F/ch/c/m/N/a/g/h/f 13133,2726401,CDM,13133,CPT,Facility,outpatient,,,,627,313.5,,,,,,,,,,,,
CpxRp E/n/e/l 1.1-2.5cm 13151,2726402,CDM,13151,CPT,Facility,outpatient,,,,1019,509.5,,,,,,,,,,,,
CpxRp E/n/e/l 1.1-2.5cm 13152,2726403,CDM,13152,CPT,Facility,outpatient,,,,1400,700,,,,,,,,,,,,
Trfr TssTrnkDf10.1-30sqcm14001,2726404,CDM,14001,CPT,Facility,outpatient,,,,3408,1704,,,,,,,,,,,,
TfrTis F/m/N/a/g/h/f<=10 14040,2726407,CDM,14040,CPT,Facility,outpatient,,,,1700,850,,,,,,,,,,,,
Atgrft SkSpT T/a/l <=100 15100,2726415,CDM,15100,CPT,Facility,outpatient,,,,4180,2090,,,,,,,,,,,,
Dst Bgn Lesn ntskntg <15 17110,2726438,CDM,17110,CPT,Facility,outpatient,,,,550.2,275.1,,,,,,,,,,,,
Dst Bgn Lsn ntskntg >=15 17111,2726439,CDM,17111,CPT,Facility,outpatient,,,,275,137.5,,,,,,,,,,,,
Chemical Cautery GranTis 17250,2726440,CDM,17250,CPT,Facility,outpatient,,,,266,133,,,,,,,,,,,,
Dst MalLsn t/a/l<0.5cmdia17260,2726441,CDM,17260,CPT,Facility,outpatient,,,,340,170,,,,,,,,,,,,
Dst Mal Lsn t/a/l0.6-1cmd17261,2726442,CDM,17261,CPT,Facility,outpatient,,,,344,172,,,,,,,,,,,,
Dst Mal Lsn t/a/l1.1-2cmd17262,2726443,CDM,17262,CPT,Facility,outpatient,,,,420,210,,,,,,,,,,,,
DstMalLnSc/n/h/f/g0.6-1cm17271,2726445,CDM,17271,CPT,Facility,outpatient,,,,352,176,,,,,,,,,,,,
DstMalLnSc/n/h/f/g1.1-2cm17272,2726446,CDM,17272,CPT,Facility,outpatient,,,,432,216,,,,,,,,,,,,
DstMlLnF/e/e/n/l/m<=0.5cm17280,2726447,CDM,17280,CPT,Facility,outpatient,,,,428,214,,,,,,,,,,,,
DstMlLnF/e/e/n/l/m .6-1. 17281,2726448,CDM,17281,CPT,Facility,outpatient,,,,400,200,,,,,,,,,,,,
DstMlLnF/e/e/n/l/m 1.1-2 17282,2726449,CDM,17282,CPT,Facility,outpatient,,,,400,200,,,,,,,,,,,,
Expl Penetr Wound Extrm 20103,2726476,CDM,20103,CPT,Facility,inpatient,,,,2373,1186.5,,,,,,,,,,,,
Bx Neck/Thorax Soft Tiss 21550,2726497,CDM,21550,CPT,Facility,inpatient,,,,1300,650,,,,,,,,,,,,
ExcNk/anthxTumSftTsSC<3cm21555,2726498,CDM,21555,CPT,Facility,inpatient,,,,1508,754,,,,,,,,,,,,
Cld Tx Humerus Fx w/o mn 23600,2726532,CDM,23600,CPT,Facility,inpatient,,,,1242.48,621.24,,,,,,,,,,,,
Manip Should Joint w/Ans 23700,2726534,CDM,23700,CPT,Facility,inpatient,,,,766.84,383.42,,,,,,,,,,,,
ClTx Humrl su/trnFx 24530,2726540,CDM,24530,CPT,Facility,inpatient,,,,1382.28,691.14,,,,,,,,,,,,
Cltx Nursmd ElbowCh w/M  24640,2726541,CDM,24640,CPT,Facility,inpatient,,,,316.84,158.42,,,,,,,,,,,,
ClTx Radial Head/neck Fx 24650,2726542,CDM,24650,CPT,Facility,inpatient,,,,963.28,481.64,,,,,,,,,,,,
ClTx Radl&Ulnr Shft w/om 25560,2726553,CDM,25560,CPT,Facility,both,,,,1018.8,509.4,,,,,,,,,,,,
ClTx Radius&Ulnar Fx w/m 25565,2726554,CDM,25565,CPT,Facility,both,,,,2046.72,1023.36,,,,,,,,,,,,
Cltx FX radius/uln w/o m 25600,2726555,CDM,25600,CPT,Facility,both,,,,669,334.5,,,,,,,,,,,,
Cltx FX radius/ulna w/mn 25605,2726556,CDM,25605,CPT,Facility,both,,,,2013.68,1006.84,,,,,,,,,,,,
ClTx Nse Fx w/Stblz 21320,2726560,CDM,21320,CPT,Facility,inpatient,,,,1241,620.5,,,,,,,,,,,,
Cl Tx Finger Fx w/o m ea 26720,2726579,CDM,26720,CPT,Facility,both,,,,739.48,369.74,,,,,,,,,,,,
Treat Finger Frct Each 26746,2726583,CDM,26746,CPT,Facility,both,,,,2907.84,1453.92,,,,,,,,,,,,
Cltx Dstl Phlnx Fx wo m  26750,2726584,CDM,26750,CPT,Facility,both,,,,985,492.5,,,,,,,,,,,,
Cltx Dstl Phlnx Fx wo m  26750,2726587,CDM,26750,CPT,Facility,both,,,,985,492.5,,,,,,,,,,,,
Inj Sacroiliac Joint 27096,2726592,CDM,27096,CPT,Facility,inpatient,,,,1300,650,,,,,,,,,,,,
Cltx Dstl Phlnx Fx wo m,2726600,CDM,267546,CPT,Facility,both,,,,820.21,410.11,,,,,,,,,,,,
ClTx Medial Malleolus Fx 27760,2726620,CDM,27760,CPT,Facility,inpatient,,,,1154,577,,,,,,,,,,,,
I&D Below Fascia Foot 28002,2726630,CDM,28002,CPT,Facility,both,,,,978.16,489.08,,,,,,,,,,,,
I&D Belw Fscia Foot Mult 28003,2726631,CDM,28003,CPT,Facility,both,,,,1504.84,752.42,,,,,,,,,,,,
Remove Foot Lesion 28090,2726636,CDM,28090,CPT,Facility,both,,,,1802,901,,,,,,,,,,,,
Apply Long Arm Cast 29065,2726664,CDM,29065,CPT,Facility,both,,,,369.48,184.74,,,,,,,,,,,,
Apply Forearm Cast 29075,2726665,CDM,29075,CPT,Facility,both,,,,322,161,,,,,,,,,,,,
App Gauntlt Hnd/wrst Cst 29085,2726666,CDM,29085,CPT,Facility,both,,,,365.8,182.9,,,,,,,,,,,,
Apply Long Arm Splint 29105,2726667,CDM,29105,CPT,Facility,both,,,,317,158.5,,,,,,,,,,,,
App Shrt Arm Splnt Static29125,2726668,CDM,29125,CPT,Facility,both,,,,311,155.5,,,,,,,,,,,,
App Finger Splint Static 29130,2726669,CDM,29130,CPT,Facility,both,,,,460,230,,,,,,,,,,,,
Apply Long Leg Cast 29345,2726671,CDM,29345,CPT,Facility,both,,,,193,96.5,,,,,,,,,,,,
Apply Short Leg Cast 29405,2726672,CDM,29405,CPT,Facility,both,,,,293,146.5,,,,,,,,,,,,
Apply Rigid TotalLeg Cst 29445,2726674,CDM,29445,CPT,Facility,both,,,,410,205,,,,,,,,,,,,
Apply Lower Leg Splint 29515,2726675,CDM,29515,CPT,Facility,both,,,,116,58,,,,,,,,,,,,
Apply Paste Boot 29580,2726677,CDM,29580,CPT,Facility,both,,,,168,84,,,,,,,,,,,,
Arthroscopy Rep SLAP Lsn 29807,2726679,CDM,29807,CPT,Facility,both,,,,94,47,,,,,,,,,,,,
Arthrscp Shldr DbrdLm1-2 29822,2726680,CDM,29822,CPT,Facility,both,,,,136,68,,,,,,,,,,,,
Arthrscp Shldr DbrdLEx3+ 29823,2726681,CDM,29823,CPT,Facility,both,,,,43,21.5,,,,,,,,,,,,
Arthscp Shldr DstClvclct 29824,2726682,CDM,29824,CPT,Facility,both,,,,6.21,3.11,,,,,,,,,,,,
Arthrscp Shldrw/LysisAdh 29825,2726683,CDM,29825,CPT,Facility,both,,,,117,58.5,,,,,,,,,,,,
Arthro Shldr Dcmp Lig rl 29826,2726684,CDM,29826,CPT,Facility,both,,,,117,58.5,,,,,,,,,,,,
ArthroscpShldr w/RttrCff 29827,2726685,CDM,29827,CPT,Facility,both,,,,117,58.5,,,,,,,,,,,,
Arthrscp Shldr Bcps Tnds 29828,2726686,CDM,29828,CPT,Facility,both,,,,117,58.5,,,,,,,,,,,,
Arthroscopy Wrist Exc/rp 29846,2726688,CDM,29846,CPT,Facility,both,,,,90,45,,,,,,,,,,,,
Wrist Endoscopy/Surgery 29848,2726689,CDM,29848,CPT,Facility,both,,,,90,45,,,,,,,,,,,,
Arthro Hip w/dbrd/shvCrt 29862,2726690,CDM,29862,CPT,Facility,both,,,,140,70,,,,,,,,,,,,
Knee Arthroscopy/Draing 29871,2726691,CDM,29871,CPT,Facility,both,,,,140,70,,,,,,,,,,,,
Arthroscopy Knee w/LatRe 29873,2726692,CDM,29873,CPT,Facility,both,,,,146,73,,,,,,,,,,,,
Arthro Knee Rem Ls or FB 29874,2726693,CDM,29874,CPT,Facility,both,,,,146,73,,,,,,,,,,,,
Arthro Knee Synvctmy Ltd 29875,2726694,CDM,29875,CPT,Facility,both,,,,146,73,,,,,,,,,,,,
Arthro Knee Syno Mjr >=2 29876,2726695,CDM,29876,CPT,Facility,both,,,,146,73,,,,,,,,,,,,
ArthroKnee AbrsnArthrplst29879,2726697,CDM,29879,CPT,Facility,both,,,,117,58.5,,,,,,,,,,,,
Arthro Knee w/Mnsct m+a 29880,2726698,CDM,29880,CPT,Facility,both,,,,117,58.5,,,,,,,,,,,,
Arthro Knee w/Mnsct m/a 29881,2726699,CDM,29881,CPT,Facility,both,,,,117,58.5,,,,,,,,,,,,
Arthro Knee w/MnscsR m/o 29882,2726700,CDM,29882,CPT,Facility,both,,,,117,58.5,,,,,,,,,,,,
Arthro Knee ACL rep 29888,2726701,CDM,29888,CPT,Facility,both,,,,117,58.5,,,,,,,,,,,,
Arthro AnkleExcOsteochDf 29891,2726702,CDM,29891,CPT,Facility,both,,,,117,58.5,,,,,,,,,,,,
Cntrl Nosebleed Ant Smp 30901,2726713,CDM,30901,CPT,Facility,both,,,,122,61,,,,,,,,,,,,
Cntrl Nosebleed Ant Comp 30903,2726714,CDM,30903,CPT,Facility,both,,,,227,113.5,,,,,,,,,,,,
Tube Thoracostomy w/drn 32551,2726755,CDM,32551,CPT,Facility,inpatient,,,,304,152,,,,,,,,,,,,
Thoracentesis ND/C w IG 32555,2726756,CDM,32555,CPT,Facility,outpatient,,,,322,161,,,,,,,,,,,,
Aspirate Bone Marrow 38220,2726861,CDM,38220,CPT,Facility,inpatient,,,,322,161,,,,,,,,,,,,
Bx/Ex LmphNds Opn Sprfcl 38500,2726865,CDM,38500,CPT,Facility,inpatient,,,,1325.64,662.82,,,,,,,,,,,,
Bx/Ex LmphNds OpDp Crvcl 38510,2726866,CDM,38510,CPT,Facility,inpatient,,,,98,49,,,,,,,,,,,,
Incision Of Tongue Fold 41010,2726879,CDM,41010,CPT,Facility,both,,,,607,303.5,,,,,,,,,,,,
Inj For Myelogram 62284,2727096,CDM,62284,CPT,Facility,inpatient,,,,761.56,380.78,,,,,,,,,,,,
Laminot (hemiLamn) lwrsp 63030,2727104,CDM,63030,CPT,Facility,inpatient,,,,3795.4,1897.7,,,,,,,,,,,,
Lamnct/Fact/Formnt  Lumb 63047,2727108,CDM,63047,CPT,Facility,inpatient,,,,4301.44,2150.72,,,,,,,,,,,,
Inj Nerve Blk Trigeminal 64400,2727114,CDM,64400,CPT,Facility,both,,,,600,300,,,,,,,,,,,,
Inj AnAg Oth Prphrl Nrv  64450,2727118,CDM,64450,CPT,Facility,both,,,,1109,554.5,,,,,,,,,,,,
Bx Ear External 69100,2727162,CDM,69100,CPT,Facility,both,,,,376.68,188.34,,,,,,,,,,,,
Exc Ext Ear Prtl Smp Rep 69110,2727163,CDM,69110,CPT,Facility,both,,,,1846.44,923.22,,,,,,,,,,,,
Rem FB Ext Aud Canal Ear 69200,2727164,CDM,69200,CPT,Facility,both,,,,184.56,92.28,,,,,,,,,,,,
Cerumen Rem instr unilat 69210,2727165,CDM,69210,CPT,Facility,both,,,,129.32,64.66,,,,,,,,,,,,
Ophth UsDx B-ScanNonq A- 76512,2727315,CDM,76512,CPT,Facility,both,,,,300,150,,,,,,,,,,,,
Echo Exam Of Eye   76516,2727318,CDM,76516,CPT,Facility,both,,,,255,127.5,,,,,,,,,,,,
Us Exam Of Head And Neck 76536,2727320,CDM,76536,CPT,Facility,both,,,,600,300,,,,,,,,,,,,
Us Eam Amdo Bck Wall Lim 76775,2727325,CDM,76775,CPT,Facility,both,,,,610,305,,,,,,,,,,,,
Ob Us < 14 Wks One Fetus 76801,2727326,CDM,76801,CPT,Facility,both,,,,672,336,,,,,,,,,,,,
Ob Us +/= 14 WksOneFetus76805,2727327,CDM,76805,CPT,Facility,both,,,,672,336,,,,,,,,,,,,
Ob Us Detailed One Fetus 76811,2727329,CDM,76811,CPT,Facility,both,,,,819,409.5,,,,,,,,,,,,
"Ob Us, Limited Fetus(S) 76815",2727332,CDM,76815,CPT,Facility,both,,,,1024,512,,,,,,,,,,,,
Transvaginal Us Obst 76817,2727334,CDM,76817,CPT,Facility,both,,,,379,189.5,,,,,,,,,,,,
US Guid For Vascl Access 76937,2727348,CDM,76937,CPT,Facility,both,,,,92,46,,,,,,,,,,,,
Medication Management 90863,2727575,CDM,90863,CPT,Facility,both,,,,5,2.5,,,,,,,,,,,,
Critical Care 1st Hour 99291,2727643,CDM,99291,CPT,Facility,both,,,,2282.22,1141.11,,,,,,,,,,,,
Critical Care Addl 30 Mn 99292,2727644,CDM,99292,CPT,Facility,both,,,,427.76,213.88,,,,,,,,,,,,
Init Nrsng Fac Care Mod 99305,2727645,CDM,99305,CPT,Facility,both,,,,497.88,248.94,,,,,,,,,,,,
Init Nursing Facil Cr HI 99306,2727647,CDM,99306,CPT,Facility,both,,,,638.96,319.48,,,,,,,,,,,,
Depression Screen Annual G0444,2727783,CDM,G0444,HCPCS,Facility,both,,,,71,35.5,,,,,,,,,,,,
Asp/inj Joint Med w/o US 20605,2966330,CDM,20605,CPT,Facility,both,,,,180,90,,,,,,,,,,,,
Spirometry 94010,2966331,CDM,94010,CPT,Facility,both,,,,427.77,213.89,,,,,,,,,,,,
Spirometry Pr/pstW/Brnch 94060,2966332,CDM,94060,CPT,Facility,both,,,,468,234,,,,,,,,,,,,
Arthrcnt Asp/InjMjrW/oUS 20610,2966333,CDM,20610,CPT,Facility,both,,,,892,446,,,,,,,,,,,,
Inj Trg Pt S/ml 1-2 Musc 20552,2966335,CDM,20552,CPT,Facility,both,,,,180,90,,,,,,,,,,,,
BENZODIAZEPINES; 1-12,3000021,CDM,80346,CPT,Facility,outpatient,,,,170,85,,,,,,,,,,,,
BENZODIAZEPINES; 13+,3000023,CDM,80347,CPT,Facility,outpatient,,,,100,50,,,,,,,,,,,,
"ANTIDEPRES, CYCLICALS; 1 OR 2",3000078,CDM,80335,CPT,Facility,outpatient,,,,85,42.5,,,,,,,,,,,,
"ANTIDEPRE, CYCLICALS; 6+",3000080,CDM,80337,CPT,Facility,outpatient,,,,4,2,,,,,,,,,,,,
DEXAMETHASONE,3000089,CDM,80299,CPT,Facility,outpatient,,,,215,107.5,,,,,,,,,,,,
AMPHETAMINES; 1 OR 2,3000098,CDM,80324,CPT,Facility,outpatient,,,,100,50,,,,,,,,,,,,
AMPHETAMINES; 3 OR 4,3000099,CDM,80325,CPT,Facility,outpatient,,,,231,115.5,,,,,,,,,,,,
AMPHETAMINES; 5+,3000100,CDM,80326,CPT,Facility,outpatient,,,,4,2,,,,,,,,,,,,
COCAINE,3000119,CDM,80353,CPT,Facility,outpatient,,,,4,2,,,,,,,,,,,,
SPECIMEN COLLECTION,3000120,CDM,C9803,HCPCS,Facility,outpatient,,,,910,455,,,,,,,,,,,,
METHADONE LEVEL BLOOD,3000133,CDM,80358,CPT,Facility,outpatient,,,,4,2,,,,,,,,,,,,
ALCOHOLS,3000187,CDM,80320,CPT,Facility,outpatient,,,,112,56,,,,,,,,,,,,
ALKALINE PHOSPHATE ISOENZYMES,3000192,CDM,84080,CPT,Facility,outpatient,,,,53,26.5,,,,,,,,,,,,
VENIPUNCTURE,3001001,CDM,36415,CPT,Facility,outpatient,,,,27,13.5,,,,,,,,,,,,
"ACETONE, SERUM, QUAL",3001002,CDM,82009,CPT,Facility,outpatient,,,,42,21,,,,,,,,,,,,
ALBUMIN SERUM,3001004,CDM,82040,CPT,Facility,outpatient,,,,77,38.5,,,,,,,,,,,,
ALKALINE PHOSPHATASE,3001005,CDM,84075,CPT,Facility,outpatient,,,,61,30.5,,,,,,,,,,,,
"AMYLASE, SERUM",3001006,CDM,82150,CPT,Facility,outpatient,,,,142,71,,,,,,,,,,,,
BILI TOTAL,3001007,CDM,82247,CPT,Facility,outpatient,,,,95,47.5,,,,,,,,,,,,
BILI DIRECT,3001008,CDM,82248,CPT,Facility,outpatient,,,,93,46.5,,,,,,,,,,,,
BUN,3001009,CDM,84520,CPT,Facility,outpatient,,,,68,34,,,,,,,,,,,,
"GLUCOSE, BLOOD",3001010,CDM,82947,CPT,Facility,outpatient,,,,60,30,,,,,,,,,,,,
CALCIUM,3001011,CDM,82310,CPT,Facility,outpatient,,,,73,36.5,,,,,,,,,,,,
CARBON DIOXIDE,3001012,CDM,82374,CPT,Facility,outpatient,,,,48,24,,,,,,,,,,,,
"Glucose, Reagent strip (FSBS)",3001013,CDM,82948,CPT,Facility,outpatient,,,,36,18,,,,,,,,,,,,
CHOLESTEROL,3001014,CDM,82465,CPT,Facility,outpatient,,,,60,30,,,,,,,,,,,,
CK/CPK TOTAL,3001015,CDM,82550,CPT,Facility,outpatient,,,,148,74,,,,,,,,,,,,
CREATININE,3001016,CDM,82565,CPT,Facility,outpatient,,,,79,39.5,,,,,,,,,,,,
DIGOXIN; TOTAL,3001017,CDM,80162,CPT,Facility,outpatient,,,,128,64,,,,,,,,,,,,
DILANTIN,3001018,CDM,80185,CPT,Facility,outpatient,,,,150,75,,,,,,,,,,,,
ABG,3001019,CDM,82803,CPT,Facility,outpatient,,,,265,132.5,,,,,,,,,,,,
MAGNESIUM,3001020,CDM,83735,CPT,Facility,outpatient,,,,120,60,,,,,,,,,,,,
PHOSPHOROUS,3001021,CDM,84100,CPT,Facility,outpatient,,,,60,30,,,,,,,,,,,,
POTASSIUM,3001022,CDM,84132,CPT,Facility,outpatient,,,,60,30,,,,,,,,,,,,
PROTEIN TOTAL,3001023,CDM,84155,CPT,Facility,outpatient,,,,80,40,,,,,,,,,,,,
PHENOBARBITAL,3001024,CDM,80184,CPT,Facility,outpatient,,,,112,56,,,,,,,,,,,,
SODIUM,3001025,CDM,84295,CPT,Facility,outpatient,,,,62,31,,,,,,,,,,,,
SALICYLATE,3001026,CDM,80179,CPT,Facility,outpatient,,,,161,80.5,,,,,,,,,,,,
THEOPHYLLINE,3001027,CDM,80198,CPT,Facility,outpatient,,,,100,50,,,,,,,,,,,,
SGOT (AST),3001028,CDM,84450,CPT,Facility,outpatient,,,,80,40,,,,,,,,,,,,
URIC ACID BLOOD,3001029,CDM,84550,CPT,Facility,outpatient,,,,75,37.5,,,,,,,,,,,,
TRIGLYCERIDES,3001030,CDM,84478,CPT,Facility,outpatient,,,,75,37.5,,,,,,,,,,,,
CKMB,3001031,CDM,82553,CPT,Facility,both,,,,140,70,,,,,,,,,,,,
RENAL PANEL,3001032,CDM,80069,CPT,Facility,both,,,,140,70,,,,,,,,,,,,
RA SCREEN,3001033,CDM,86430,CPT,Facility,both,,,,143,71.5,,,,,,,,,,,,
CBC W/ AUTO DIFF,3001035,CDM,85025,CPT,Facility,both,,,,210,105,,,,,,,,,,,,
RBC,3001036,CDM,85041,CPT,Facility,both,,,,38,19,,,,,,,,,,,,
ACETAMINOPHEN,3001037,CDM,80143,CPT,Facility,both,,,,170,85,,,,,,,,,,,,
HEMATOCRIT,3001038,CDM,85014,CPT,Facility,both,,,,43,21.5,,,,,,,,,,,,
HEMOGLOBIN,3001039,CDM,85018,CPT,Facility,both,,,,43,21.5,,,,,,,,,,,,
CBC W/O DIFF,3001040,CDM,85027,CPT,Facility,both,,,,1055,527.5,,,,,,,,,,,,
SED RATE,3001041,CDM,85651,CPT,Facility,both,,,,80,40,,,,,,,,,,,,
PROTHROMBIN TIME,3001043,CDM,85610,CPT,Facility,both,,,,106,53,,,,,,,,,,,,
PTT,3001044,CDM,85730,CPT,Facility,both,,,,100,50,,,,,,,,,,,,
URINALYSIS (+),3001046,CDM,81001, CPT,Facility,outpatient,,,,136,68,,,,,,,,,,,,
URINE MICROSCOPIC ONLY,3001047,CDM,81015,CPT,Facility,both,,,,46,23,,,,,,,,,,,,
URINE PREGNANCY,3001048,CDM,81025, CPT,Facility,outpatient,,,,131,65.5,,,,,,,,,,,,
OCCULT 1-3,3001049,CDM,82270, CPT,Facility,outpatient,,,,17.52,8.76,,,,,,,,,,,,
URINE PREGNANCY,3001050,CDM,81025,CPT,Facility,both,,,,131,65.5,,,,,,,,,,,,
CULTURE ROUT,3001051,CDM,87070,CPT,Facility,both,,,,180,90,,,,,,,,,,,,
CULTURE BLOOD,3001052,CDM,87040,CPT,Facility,both,,,,155,77.5,,,,,,,,,,,,
PRESUMPTIVE ID URINE,3001053,CDM,87088,CPT,Facility,both,,,,120,60,,,,,,,,,,,,
TSH,3001054,CDM,84443,CPT,Facility,both,,,,175,87.5,,,,,,,,,,,,
GRAM STAIN,3001055,CDM,87205,CPT,Facility,both,,,,75,37.5,,,,,,,,,,,,
SENSITIVITY,3001057,CDM,87186,CPT,Facility,both,,,,98,49,,,,,,,,,,,,
"WET MOUNT, TISSUE EXAMINATION",3001058,CDM,87210, CPT,Facility,outpatient,,,,17.08,8.54,,,,,,,,,,,,
CULTURE THROAT (STREP A SCREEN),3001059,CDM,87081,CPT,Facility,both,,,,100,50,,,,,,,,,,,,
THER PHLEBOTOMY,3001062,CDM,99195,CPT,Facility,both,,,,201,100.5,,,,,,,,,,,,
LIPID PANEL,3001064,CDM,80061,CPT,Facility,both,,,,190,95,,,,,,,,,,,,
SGPT (ALT),3001065,CDM,84460,CPT,Facility,both,,,,83,41.5,,,,,,,,,,,,
RAPID STREP A,3001066,CDM,87880,CPT,Facility,both,,,,64,32,,,,,,,,,,,,
CSF CELL CT,3001067,CDM,84999, CPT,Facility,outpatient,,,,22.4,11.2,,,,,,,,,,,,
PROTEIN CSF/BODY FLUID,3001068,CDM,84157,CPT,Facility,both,,,,100,50,,,,,,,,,,,,
"GLUCOSE, CSF",3001069,CDM,82945, CPT,Facility,outpatient,,,,80,40,,,,,,,,,,,,
LIVER PANEL,3001071,CDM,80076,CPT,Facility,both,,,,185,92.5,,,,,,,,,,,,
COMPREHENSIVE METABOLIC PANEL,3001072,CDM,80053,CPT,Facility,both,,,,350,175,,,,,,,,,,,,
BASIC METAB PANEL,3001073,CDM,80048,CPT,Facility,both,,,,67,33.5,,,,,,,,,,,,
GENTAMICIN,3001074,CDM,80170,CPT,Facility,both,,,,155,77.5,,,,,,,,,,,,
CARBAMAZEPINE,3001075,CDM,80156,CPT,Facility,both,,,,166,83,,,,,,,,,,,,
VALPROIC ACID; TOTAL,3001080,CDM,80164,CPT,Facility,both,,,,168,84,,,,,,,,,,,,
STOOL WBC,3001081,CDM,89055,CPT,Facility,both,,,,50,25,,,,,,,,,,,,
VENOUS PH,3001082,CDM,82800,CPT,Facility,both,,,,262,131,,,,,,,,,,,,
RSV,3001083,CDM,87634,CPT,Facility,both,,,,91,45.5,,,,,,,,,,,,
LIPASE,3001085,CDM,83690,CPT,Facility,both,,,,140,70,,,,,,,,,,,,
ARTERIAL PUNCTURE,3001086,CDM,36600,CPT,Facility,both,,,,138,69,,,,,,,,,,,,
CULTURE ID DEFENITIV,3001087,CDM,87077,CPT,Facility,both,,,,85,42.5,,,,,,,,,,,,
GTT (FIRST 3 SPECIMENS),3001088,CDM,82950, CPT,Facility,outpatient,,,,51.48,25.74,,,,,,,,,,,,
GTT: EA. ADD. SPECI.,3001089,CDM,82951, CPT,Facility,outpatient,,,,15.68,7.84,,,,,,,,,,,,
GLUCOSE POST INCLUD,3001090,CDM,82951, CPT,Facility,outpatient,,,,19,9.5,,,,,,,,,,,,
FOLATE (FOLIC ACID),3001093,CDM,82746,CPT,Facility,both,,,,170,85,,,,,,,,,,,,
T4 (THYROXINE),3001094,CDM,84436,CPT,Facility,both,,,,95,47.5,,,,,,,,,,,,
MYOGLOBIN,3001095,CDM,83874,CPT,Facility,both,,,,80,40,,,,,,,,,,,,
TROPONIN,3001096,CDM,84484,CPT,Facility,both,,,,230,115,,,,,,,,,,,,
MANUAL DIFFERENTIAL,3001097,CDM,85007,CPT,Facility,both,,,,45,22.5,,,,,,,,,,,,
PH BODY FLUID,3001098,CDM,83986,CPT,Facility,both,,,,37,18.5,,,,,,,,,,,,
URINE MICROALBUMIN QUANT,3001099,CDM,82043, CPT,Facility,outpatient,,,,85,42.5,,,,,,,,,,,,
ORA OUICK HIV,3001100,CDM,87389,CPT,Facility,both,,,,160,80,,,,,,,,,,,,
PSA (SCREENING),3001101,CDM,84153,CPT,Facility,both,,,,138,69,,,,,,,,,,,,
INFLUENZA A,3001102,CDM,87804,CPT,Facility,both,,,,91,45.5,,,,,,,,,,,,
VANCOMYCIN PEAK,3001104,CDM,80202,CPT,Facility,both,,,,184,92,,,,,,,,,,,,
KOH WET PREP,3001105,CDM,87210,CPT,Facility,both,,,,69,34.5,,,,,,,,,,,,
CULTURE URINE QUANT EACH,3001106,CDM,87086,CPT,Facility,both,,,,120,60,,,,,,,,,,,,
PREGNANCY SERUM QUAL,3001107,CDM,84703,CPT,Facility,both,,,,130,65,,,,,,,,,,,,
D-DIMER QNT,3001108,CDM,85379,CPT,Facility,both,,,,253,126.5,,,,,,,,,,,,
BNP-NATRIURETIC PEP.,3001110,CDM,83880,CPT,Facility,both,,,,300,150,,,,,,,,,,,,
LDL CHOLESTEROL,3001118,CDM,83721,CPT,Facility,both,,,,65,32.5,,,,,,,,,,,,
VENOUS BLOOD GAS,3001119,CDM,82805,CPT,Facility,both,,,,265,132.5,,,,,,,,,,,,
HDL,3001120,CDM,83718,CPT,Facility,both,,,,55,27.5,,,,,,,,,,,,
VITAMIN A,3001121,CDM,84590,CPT,Facility,both,,,,53,26.5,,,,,,,,,,,,
ANGIOTEN I CONVERT ENZYME,3001123,CDM,82164,CPT,Facility,both,,,,139,69.5,,,,,,,,,,,,
HEPATITIS PANEL ACUTE,3001124,CDM,80074,CPT,Facility,both,,,,347,173.5,,,,,,,,,,,,
"ALLERGEN SPECIFIC IGE QUANT, EACH",3001126,CDM,86003,CPT,Facility,both,,,,39,19.5,,,,,,,,,,,,
AMMONIA,3001127,CDM,82140,CPT,Facility,both,,,,163,81.5,,,,,,,,,,,,
ANALYTE IMMUNOASSAY,3001131,CDM,83516,CPT,Facility,both,,,,46.12,23.06,,,,,,,,,,,,
ANDROSTENEDIONE,3001132,CDM,82157,CPT,Facility,both,,,,473,236.5,,,,,,,,,,,,
ANTITHYROGLOBULIN ANTIB,3001133,CDM,86800,CPT,Facility,both,,,,90,45,,,,,,,,,,,,
ANA CASCADING ANTIB,3001134,CDM,86038,CPT,Facility,both,,,,117,58.5,,,,,,,,,,,,
CA 125,3001136,CDM,86304,CPT,Facility,both,,,,143,71.5,,,,,,,,,,,,
CALCIUM IONIZED ASSAY OF,3001137,CDM,82330,CPT,Facility,both,,,,96,48,,,,,,,,,,,,
CARBOXYHEMOGLOBIN QUANT,3001138,CDM,82375,CPT,Facility,both,,,,98,49,,,,,,,,,,,,
CARCINOEMBRYONIC ANTIGEN CEA,3001139,CDM,82378,CPT,Facility,both,,,,213,106.5,,,,,,,,,,,,
CHYLMD TRACH DNA DIR PROBE,3001141,CDM,87490,CPT,Facility,both,,,,115,57.5,,,,,,,,,,,,
CLOSTRIDIUM DIFFICILE,3001142,CDM,87324,CPT,Facility,both,,,,195,97.5,,,,,,,,,,,,
C-PEPTIDE,3001145,CDM,84681,CPT,Facility,both,,,,203,101.5,,,,,,,,,,,,
C-REACTIVE PROTEIN,3001146,CDM,86140,CPT,Facility,both,,,,97,48.5,,,,,,,,,,,,
CREATININE CLEARANCE,3001147,CDM,82575,CPT,Facility,both,,,,118,59,,,,,,,,,,,,
CREATININE OTHER SOURCE,3001148,CDM,82570,CPT,Facility,both,,,,88,44,,,,,,,,,,,,
CRYSTAL IDENT TISS/BODY FLUID,3001149,CDM,89060,CPT,Facility,both,,,,110,55,,,,,,,,,,,,
CYCLIC CITRULNATED PEPTIDE CCP,3001151,CDM,86200,CPT,Facility,both,,,,218,109,,,,,,,,,,,,
EHRLICHIA ANTIBODY,3001155,CDM,86666,CPT,Facility,both,,,,185,92.5,,,,,,,,,,,,
ESTRADIOL,3001159,CDM,82670,CPT,Facility,both,,,,190,95,,,,,,,,,,,,
ESTROGEN TOTAL,3001160,CDM,82672,CPT,Facility,both,,,,150,75,,,,,,,,,,,,
"FECAL FAT, QUAL",3001163,CDM,82705,CPT,Facility,both,,,,145,72.5,,,,,,,,,,,,
FERRITIN,3001165,CDM,82728,CPT,Facility,both,,,,160,80,,,,,,,,,,,,
FSH,3001166,CDM,83001,CPT,Facility,both,,,,196,98,,,,,,,,,,,,
"IMMUNOGLOBULIN IGE, TOTAL",3001168,CDM,82785,CPT,Facility,both,,,,80,40,,,,,,,,,,,,
GLUTAMYLTRANSFERASE GAMMA GGT,3001171,CDM,82977,CPT,Facility,both,,,,68,34,,,,,,,,,,,,
HEMOGLOBIN A1C GLYCATED,3001175,CDM,83036,CPT,Facility,both,,,,123,61.5,,,,,,,,,,,,
HEPATITIS C GENOTYPE DNA,3001176,CDM,87902,CPT,Facility,both,,,,383,191.5,,,,,,,,,,,,
HEPATITIS C RNA QUANT,3001177,CDM,87521, CPT,Facility,outpatient,,,,633,316.5,,,,,,,,,,,,
HIV-1 DNA AMP PROBE,3001178,CDM,87535,CPT,Facility,both,,,,545,272.5,,,,,,,,,,,,
HLA TYPING A B OR C,3001179,CDM,86812,CPT,Facility,both,,,,203,101.5,,,,,,,,,,,,
HYDROXYPROGESTERONE 17 D,3001180,CDM,83498,CPT,Facility,both,,,,205,102.5,,,,,,,,,,,,
INSULIN TOTAL,3001183,CDM,83525,CPT,Facility,both,,,,140,70,,,,,,,,,,,,
IRON,3001184,CDM,83540,CPT,Facility,both,,,,93,46.5,,,,,,,,,,,,
IRON BINDING CAPACITY,3001185,CDM,83550,CPT,Facility,both,,,,90,45,,,,,,,,,,,,
LDH (LACTATE DEHYDROGENASE),3001186,CDM,83615,CPT,Facility,both,,,,88,44,,,,,,,,,,,,
LEAD LEVEL (PLASMA),3001187,CDM,83655,CPT,Facility,both,,,,95,47.5,,,,,,,,,,,,
LEGIONELLA PNEUMOPHILIA,3001188,CDM,87481, CPT,Facility,outpatient,,,,62.4,31.2,,,,,,,,,,,,
LH,3001189,CDM,83002,CPT,Facility,both,,,,205,102.5,,,,,,,,,,,,
LITHIUM,3001190,CDM,80178,CPT,Facility,both,,,,95,47.5,,,,,,,,,,,,
"LYME DISEASE ANTIBODY, WESTERN",3001191,CDM,86617,CPT,Facility,both,,,,175,87.5,,,,,,,,,,,,
MYCOPLASMA ANTIBODY,3001192,CDM,86738,CPT,Facility,both,,,,125,62.5,,,,,,,,,,,,
OCCULT 1-3,3001193,CDM,82272,CPT,Facility,outpatient,,,,55,27.5,,,,,,,,,,,,
OSMOLALITY BLOOD,3001196,CDM,83930,CPT,Facility,both,,,,65,32.5,,,,,,,,,,,,
OSMOLALITY URINE,3001197,CDM,83935,CPT,Facility,both,,,,78,39,,,,,,,,,,,,
PARATHYROID HORMONE,3001199,CDM,83970,CPT,Facility,both,,,,370,185,,,,,,,,,,,,
PREALBUMIN,3001202,CDM,84134,CPT,Facility,both,,,,70,35,,,,,,,,,,,,
PROGESTERONE,3001204,CDM,84144,CPT,Facility,both,,,,145,72.5,,,,,,,,,,,,
PROTEIN CSF/URINE ELECPHORE,3001205,CDM,84166,CPT,Facility,both,,,,105,52.5,,,,,,,,,,,,
PROTEIN SERUM ELEHORESIS,3001206,CDM,84165,CPT,Facility,both,,,,105,52.5,,,,,,,,,,,,
PROTEIN URINE,3001207,CDM,84156,CPT,Facility,both,,,,122,61,,,,,,,,,,,,
Punch biopsy of skin,3001209,CDM,11104,CPT,Facility,outpatient,,,,480,240,,,,,,,,,,,,
RENIN,3001210,CDM,84244,CPT,Facility,both,,,,168,84,,,,,,,,,,,,
RHEUMATOID FACTOR QUTIVE,3001214,CDM,86431,CPT,Facility,both,,,,50,25,,,,,,,,,,,,
RICKETTSIA ANTIBODY W/REFLEX,3001215,CDM,86757,CPT,Facility,outpatient,,,,125,62.5,,,,,,,,,,,,
ROTAVIRUS,3001216,CDM,87425,CPT,Facility,both,,,,185,92.5,,,,,,,,,,,,
SPECTROPHOTOMETRY,3001218,CDM,84311,CPT,Facility,both,,,,134,67,,,,,,,,,,,,
TESTOSTERONE TOTAL,3001221,CDM,84403,CPT,Facility,both,,,,168,84,,,,,,,,,,,,
THYROID (T3/T4) RATIO/UPTAKE,3001222,CDM,84479,CPT,Facility,both,,,,105,52.5,,,,,,,,,,,,
TRANSFERRIN,3001224,CDM,84466,CPT,Facility,both,,,,138,69,,,,,,,,,,,,
URINALYSIS NON-AUTO W/MICRO,3001226,CDM,81001, CPT,Facility,outpatient,,,,136,68,,,,,,,,,,,,
URINE MICROALBUMIN QUANT,3001227,CDM,82043, CPT,Facility,outpatient,,,,85,42.5,,,,,,,,,,,,
URINE VOLUME MEASURMENT,3001234,CDM,81050,CPT,Facility,both,,,,36,18,,,,,,,,,,,,
"5 HIAA,QN URINE",3001235,CDM,83497,CPT,Facility,both,,,,70,35,,,,,,,,,,,,
ABSORPTION OF RBC,3001238,CDM,86978,CPT,Facility,both,,,,160,80,,,,,,,,,,,,
ACID FAST SMEAR,3001240,CDM,87206,CPT,Facility,both,,,,92,46,,,,,,,,,,,,
ACID PHOS PROSTATIC,3001241,CDM,84066,CPT,Facility,both,,,,63,31.5,,,,,,,,,,,,
ACTH,3001242,CDM,82024,CPT,Facility,both,,,,208,104,,,,,,,,,,,,
ALDOLASE,3001246,CDM,82085,CPT,Facility,both,,,,129,64.5,,,,,,,,,,,,
ALDOSTERONE,3001247,CDM,82088,CPT,Facility,both,,,,315,157.5,,,,,,,,,,,,
ALPHA-FETOPROTEIN TUMOR MARKER,3001248,CDM,82105,CPT,Facility,both,,,,135,67.5,,,,,,,,,,,,
ALPHA-1-ANTITRYPSIN TOTAL,3001249,CDM,82103,CPT,Facility,both,,,,171,85.5,,,,,,,,,,,,
ANCA,3001256,CDM,86021,CPT,Facility,both,,,,60.2,30.1,,,,,,,,,,,,
ANTI-DS DNA,3001257,CDM,86225,CPT,Facility,both,,,,120,60,,,,,,,,,,,,
ANTIBODY IDENTIFICATION,3001259,CDM,86870,CPT,Facility,both,,,,240,120,,,,,,,,,,,,
ASO,3001262,CDM,86060,CPT,Facility,both,,,,89,44.5,,,,,,,,,,,,
BETA 2 MICROGLOBULIN SERUM,3001263,CDM,82232,CPT,Facility,both,,,,144,72,,,,,,,,,,,,
B-FLOW CYTOMETRY ORIGIN,3001265,CDM,88184,CPT,Facility,both,,,,126,63,,,,,,,,,,,,
BENCE JONES PROTEIN,3001268,CDM,86325,CPT,Facility,both,,,,92.52,46.26,,,,,,,,,,,,
BRUCELLA ANTIBODY,3001270,CDM,86622,CPT,Facility,both,,,,120,60,,,,,,,,,,,,
"ALKALOIDS, NOS",3001271,CDM,80323,CPT,Facility,both,,,,100,50,,,,,,,,,,,,
BLOOD BANK ANTIBODY SCREEN,3001273,CDM,86850,CPT,Facility,both,,,,160,80,,,,,,,,,,,,
BLD TYPING; RH,3001276,CDM,86901,CPT,Facility,both,,,,95,47.5,,,,,,,,,,,,
BLD TYPING; ABO,3001281,CDM,86900,CPT,Facility,both,,,,85,42.5,,,,,,,,,,,,
C. DIFF TOXIN B,3001283,CDM,87230,CPT,Facility,both,,,,190,95,,,,,,,,,,,,
CA 19-9,3001285,CDM,86301,CPT,Facility,both,,,,133,66.5,,,,,,,,,,,,
CALCIUM URINE,3001286,CDM,82340,CPT,Facility,both,,,,68,34,,,,,,,,,,,,
ANTIPSYCHOTICS; 1-3,3001291,CDM,80342,CPT,Facility,both,,,,57,28.5,,,,,,,,,,,,
BARBITURATES,3001294,CDM,80345,CPT,Facility,both,,,,85,42.5,,,,,,,,,,,,
CH50-COMPLEMENT TOTAL HEMOLYIC,3001300,CDM,86162,CPT,Facility,both,,,,155,77.5,,,,,,,,,,,,
CHLORIDE SERUM,3001302,CDM,82435,CPT,Facility,both,,,,38,19,,,,,,,,,,,,
CHOLINESTERASE SERUM OR PLASMA,3001304,CDM,82480,CPT,Facility,both,,,,120,60,,,,,,,,,,,,
"DRUG CONFIRMATION, 8-14",3001305,CDM,G0481,HCPCS,Facility,both,,,,22.86,11.43,,,,,,,,,,,,
"DRUG CONFIRMATION, 1-7",3001306,CDM,G0480,HCPCS,Facility,both,,,,25,12.5,,,,,,,,,,,,
"DRUG CONFIRMATION, 15-21",3001307,CDM,G0482,HCPCS,Facility,both,,,,495,247.5,,,,,,,,,,,,
"DRUG CONFIRMATION, 22+",3001308,CDM,G0483,HCPCS,Facility,both,,,,485.84,242.92,,,,,,,,,,,,
CMV IGG,3001312,CDM,86644,CPT,Facility,both,,,,125,62.5,,,,,,,,,,,,
COLD AGGLUTININS SCREEN,3001314,CDM,86156,CPT,Facility,both,,,,112,56,,,,,,,,,,,,
BETA-HYDROXYBUTYRATE,3001316,CDM,82010,CPT,Facility,outpatient,,,,110,55,,,,,,,,,,,,
"CANNABINOIDS, NATURAL",3001319,CDM,80349,CPT,Facility,outpatient,,,,100,50,,,,,,,,,,,,
CREATININE URINE RANDOM,3001320,CDM,82570,CPT,Facility,both,,,,88,44,,,,,,,,,,,,
CROSS MATCH ANTIGLOBULIN (AHG),3001321,CDM,86922,CPT,Facility,both,,,,165,82.5,,,,,,,,,,,,
"CRP, HIGH SENSITIVITY",3001322,CDM,86141,CPT,Facility,both,,,,188,94,,,,,,,,,,,,
CULTURE ACID FAST,3001324,CDM,87116,CPT,Facility,both,,,,175,87.5,,,,,,,,,,,,
CULTURE FUNGAL OTHERS,3001325,CDM,87102,CPT,Facility,both,,,,105,52.5,,,,,,,,,,,,
CULTURE STOOL SALMONELA/SHIGEL,3001326,CDM,87045,CPT,Facility,both,,,,175,87.5,,,,,,,,,,,,
CULTURE ID BLOOD,3001328,CDM,87103,CPT,Facility,both,,,,85,42.5,,,,,,,,,,,,
CYCLOSPORIN,3001331,CDM,80158,CPT,Facility,both,,,,245,122.5,,,,,,,,,,,,
"DAT,DIRECT COOMBS",3001336,CDM,86880,CPT,Facility,both,,,,95,47.5,,,,,,,,,,,,
DHEA,3001337,CDM,82626,CPT,Facility,both,,,,148,74,,,,,,,,,,,,
DHEA-S,3001338,CDM,82627,CPT,Facility,both,,,,140,70,,,,,,,,,,,,
"EBV ANTIBODIES EARLY IgG, Ag",3001343,CDM,86663,CPT,Facility,both,,,,200,100,,,,,,,,,,,,
TISSUE TRANSGLUTAMINASE,3001346,CDM,86364,CPT,Facility,outpatient,,,,29,14.5,,,,,,,,,,,,
FIBRINOGEN ACTIVITY,3001356,CDM,85384,CPT,Facility,outpatient,,,,115,57.5,,,,,,,,,,,,
URINALYSIS AUTO W/MICRO,3001358,CDM,81001,CPT,Facility,both,,,,136,68,,,,,,,,,,,,
FREE THYROXINE FT4,3001359,CDM,84439,CPT,Facility,both,,,,133,66.5,,,,,,,,,,,,
FT 3(FREE T3),3001361,CDM,84481,CPT,Facility,both,,,,190,95,,,,,,,,,,,,
G C PROBE,3001362,CDM,87591,CPT,Facility,both,,,,85,42.5,,,,,,,,,,,,
BETA-HCG QUANT SERUM,3001366,CDM,84702,CPT,Facility,both,,,,205,102.5,,,,,,,,,,,,
GROWTH HORMONE,3001367,CDM,83003,CPT,Facility,both,,,,95,47.5,,,,,,,,,,,,
HEPATITIS B SURFACE AG,3001368,CDM,87340,CPT,Facility,both,,,,107,53.5,,,,,,,,,,,,
RESP PATHOGEN PANEL,3001369,CDM,87486; 87581; 87633; 87798,CPT,Facility,both,,,,620,310,,,,,,,,,,,,
HEP B CORE Ab TOTAL,3001371,CDM,86704,CPT,Facility,both,,,,115,57.5,,,,,,,,,,,,
HEP BE ANTIBODY,3001372,CDM,86707,CPT,Facility,both,,,,105,52.5,,,,,,,,,,,,
HEP BE ANTIGEN,3001373,CDM,87350,CPT,Facility,both,,,,102,51,,,,,,,,,,,,
HEP C VIRUS RNA-PCR QL,3001374,CDM,87521,CPT,Facility,both,,,,633,316.5,,,,,,,,,,,,
HEPATITIS B SURFACE AB,3001375,CDM,86706,CPT,Facility,both,,,,105,52.5,,,,,,,,,,,,
HEPATITIS A ANTIBODY,3001376,CDM,86708,CPT,Facility,both,,,,140,70,,,,,,,,,,,,
HEPATITIS B DNA AMP PROBE,3001377,CDM,87522, CPT,Facility,outpatient,,,,140.36,70.18,,,,,,,,,,,,
HEPATITIS C ANTIBODY,3001378,CDM,86803,CPT,Facility,both,,,,185,92.5,,,,,,,,,,,,
HOMOCYSTINE,3001390,CDM,83090,CPT,Facility,both,,,,290,145,,,,,,,,,,,,
INSULIN LIKE GFB PROTEIN III,3001400,CDM,83520,CPT,Facility,both,,,,8.63,4.32,,,,,,,,,,,,
LACTATE (LACTIC ACID),3001404,CDM,83605,CPT,Facility,both,,,,104,52,,,,,,,,,,,,
LUPUS ANTICOAGULANT,3001408,CDM,85613,CPT,Facility,both,,,,38.32,19.16,,,,,,,,,,,,
PROPOXYPHENE,3001411,CDM,80367,CPT,Facility,both,,,,4,2,,,,,,,,,,,,
METANEPHRINE,3001415,CDM,83835,CPT,Facility,both,,,,211,105.5,,,,,,,,,,,,
MRSA SCREEN,3001416,CDM,87081,CPT,Facility,both,,,,100,50,,,,,,,,,,,,
MUMPS ANTIBODY,3001417,CDM,86735,CPT,Facility,both,,,,125,62.5,,,,,,,,,,,,
"ORGANIC ACIDS, QUAL, URINE",3001421,CDM,83919,CPT,Facility,both,,,,65.8,32.9,,,,,,,,,,,,
OVA & PARASITES,3001422,CDM,87177,CPT,Facility,both,,,,100,50,,,,,,,,,,,,
PKU STATE,3001428,CDM,84030,CPT,Facility,both,,,,205,102.5,,,,,,,,,,,,
PLATELET COUNT,3001429,CDM,85049,CPT,Facility,both,,,,75,37.5,,,,,,,,,,,,
PRO-INSULIN,3001433,CDM,84206,CPT,Facility,both,,,,320,160,,,,,,,,,,,,
PROLACTIN,3001434,CDM,84146,CPT,Facility,both,,,,220,110,,,,,,,,,,,,
PROCALCITONIN,3001435,CDM,84145,CPT,Facility,both,,,,580,290,,,,,,,,,,,,
OPIATES; 1+,3001436,CDM,80361,CPT,Facility,both,,,,150,75,,,,,,,,,,,,
OPIOIDS/OPIATE ANALOGS; 1 OR 2,3001437,CDM,80362,CPT,Facility,both,,,,100,50,,,,,,,,,,,,
OPIOIDS/OPIATE ANALOGS; 3 OR 4,3001438,CDM,80363,CPT,Facility,both,,,,339,169.5,,,,,,,,,,,,
PROTEIN C ANTIGEN,3001439,CDM,85302,CPT,Facility,both,,,,212,106,,,,,,,,,,,,
PROTEIN S TOTAL,3001440,CDM,85305,CPT,Facility,both,,,,193,96.5,,,,,,,,,,,,
OPIOIDS/OPIATE ANALOGS; 5+,3001442,CDM,80364,CPT,Facility,both,,,,325,162.5,,,,,,,,,,,,
OXYCODONE,3001443,CDM,80365,CPT,Facility,both,,,,53,26.5,,,,,,,,,,,,
RBC MAGNESIUM,3001444,CDM,83735, CPT,Facility,outpatient,,,,120,60,,,,,,,,,,,,
PSA FREE,3001448,CDM,84154,CPT,Facility,both,,,,83,41.5,,,,,,,,,,,,
THYROGLOBULIN,3001450,CDM,84432,CPT,Facility,both,,,,97,48.5,,,,,,,,,,,,
"QUINIDINE, QUANT",3001451,CDM,80194,CPT,Facility,both,,,,157,78.5,,,,,,,,,,,,
"CANNABINOIDS, SYNTHETIC;",3001455,CDM,80352,CPT,Facility,both,,,,243,121.5,,,,,,,,,,,,
PREGNENOLONE,3001466,CDM,84140,CPT,Facility,both,,,,123,61.5,,,,,,,,,,,,
RUBELLA ANTIBODY,3001475,CDM,86762,CPT,Facility,both,,,,100,50,,,,,,,,,,,,
RUBEOLA ANTIBODY (MEASLES),3001476,CDM,86765,CPT,Facility,both,,,,125,62.5,,,,,,,,,,,,
"CORTISOL, SERUM",3001479,CDM,82533,CPT,Facility,both,,,,158,79,,,,,,,,,,,,
"GASTRIN, SERUM",3001480,CDM,82941,CPT,Facility,both,,,,145,72.5,,,,,,,,,,,,
SKELETAL MUSCLE REL; 3+,3001487,CDM,80370,CPT,Facility,both,,,,4,2,,,,,,,,,,,,
SOMATOMEDIN-C,3001489,CDM,84305,CPT,Facility,both,,,,135,67.5,,,,,,,,,,,,
STREPTOZYME,3001496,CDM,86001, CPT,Facility,outpatient,,,,23.08,11.54,,,,,,,,,,,,
SYNOVIAL FLUID CELL COUNT,3001498,CDM,89050,CPT,Facility,both,,,,110,55,,,,,,,,,,,,
KETAMINE AND NORKETAMINE,3001500,CDM,80357,CPT,Facility,both,,,,4,2,,,,,,,,,,,,
TRIIODOTHYRONINE (T3)TOTAL TT3,3001507,CDM,84480,CPT,Facility,both,,,,145,72.5,,,,,,,,,,,,
TULAREMIA,3001508,CDM,86356, CPT,Facility,outpatient,,,,27.92,13.96,,,,,,,,,,,,
URIC ACID BODY FLUID,3001510,CDM,84560,CPT,Facility,both,,,,55,27.5,,,,,,,,,,,,
CORTISOL  FREE,3001511,CDM,82530,CPT,Facility,outpatient,,,,139,69.5,,,,,,,,,,,,
UA DIPSTICK NON-AUTO W/O MICRO,3001513,CDM,81002,CPT,Facility,both,,,,32,16,,,,,,,,,,,,
POTASSIUM URINE,3001514,CDM,84133,CPT,Facility,both,,,,48,24,,,,,,,,,,,,
VANILLYLMANDELIC(VMA)QUNT,3001515,CDM,84585,CPT,Facility,both,,,,121,60.5,,,,,,,,,,,,
VITAMIN B12,3001523,CDM,82607,CPT,Facility,both,,,,158,79,,,,,,,,,,,,
WBC COUNT ONLY,3001524,CDM,85048,CPT,Facility,both,,,,43,21.5,,,,,,,,,,,,
"WET MOUNT, INFECTIOUS AGENTS",3001528,CDM,87205, CPT,Facility,outpatient,,,,23.28,11.64,,,,,,,,,,,,
ZINC SERUM,3001531,CDM,84630,CPT,Facility,both,,,,68,34,,,,,,,,,,,,
CD4 COUNT PAR,3001536,CDM,86361,CPT,Facility,both,,,,355,177.5,,,,,,,,,,,,
FLUORESCENT ANTIBODY SCREEN,3001554,CDM,86255, CPT,Facility,outpatient,,,,48.2,24.1,,,,,,,,,,,,
CHLORIDE URINE,3001555,CDM,82436,CPT,Facility,both,,,,65,32.5,,,,,,,,,,,,
CREATININE URINE 24 HOUR,3001556,CDM,82570,CPT,Facility,both,,,,88,44,,,,,,,,,,,,
"PSA, TOTAL",3001561,CDM,84153,CPT,Facility,both,,,,138,69,,,,,,,,,,,,
SJOGREN'S ANTIBODIES QUANT,3001563,CDM,86235, CPT,Facility,outpatient,,,,71.72,35.86,,,,,,,,,,,,
ZONISAMIDE,3001565,CDM,80203,CPT,Facility,both,,,,213,106.5,,,,,,,,,,,,
BAP BONE-SPECIFIC ALkPHos,3001571,CDM,83937, CPT,Facility,outpatient,,,,59.12,29.56,,,,,,,,,,,,
ANTIMITOCHONDRIAL A,3001577,CDM,86255, CPT,Facility,outpatient,,,,46.12,23.06,,,,,,,,,,,,
TOPIRAMATE,3001578,CDM,80201,CPT,Facility,both,,,,184,92,,,,,,,,,,,,
INSULIN ANTIBODY,3001580,CDM,83519, CPT,Facility,outpatient,,,,46.12,23.06,,,,,,,,,,,,
ACETYLCHOLINE RECEPTR ANTIBODY,3001582,CDM,83516, CPT,Facility,outpatient,,,,73.6,36.8,,,,,,,,,,,,
THROMBIN TIME,3001583,CDM,85670,CPT,Facility,both,,,,54,27,,,,,,,,,,,,
RETIC COUNT AUTO,3001584,CDM,85045,CPT,Facility,both,,,,45,22.5,,,,,,,,,,,,
ALUMINUM,3001587,CDM,82108,CPT,Facility,both,,,,55,27.5,,,,,,,,,,,,
AMINOLEVULINIC,3001591,CDM,82135,CPT,Facility,both,,,,184,92,,,,,,,,,,,,
CITRIC 24HR URINE,3001594,CDM,82507,CPT,Facility,both,,,,187,93.5,,,,,,,,,,,,
URINE PROTEIN 24 HOUR,3001596,CDM,84156,CPT,Facility,both,,,,122,61,,,,,,,,,,,,
HYDROXY 24 HR URINE,3001598,CDM,83491,CPT,Facility,both,,,,52,26,,,,,,,,,,,,
MERCURY BLOOD,3001601,CDM,83825,CPT,Facility,both,,,,100,50,,,,,,,,,,,,
METHYLMALONIC ACID,3001602,CDM,83921,CPT,Facility,both,,,,243,121.5,,,,,,,,,,,,
CLOZAPINE,3001605,CDM,80159,CPT,Facility,both,,,,222,111,,,,,,,,,,,,
CMV IGM,3001609,CDM,86645,CPT,Facility,both,,,,125,62.5,,,,,,,,,,,,
PROCAINAMIDE,3001610,CDM,80192,CPT,Facility,both,,,,141,70.5,,,,,,,,,,,,
TACROLIMUS (FK 506),3001615,CDM,80197,CPT,Facility,both,,,,105,52.5,,,,,,,,,,,,
CA 27.29 (15-3),3001616,CDM,86300,CPT,Facility,both,,,,165,82.5,,,,,,,,,,,,
ANTITHROMBIN 3 AG,3001620,CDM,85301,CPT,Facility,both,,,,43,21.5,,,,,,,,,,,,
ANTITHRO 3 ACT,3001621,CDM,85300,CPT,Facility,both,,,,215,107.5,,,,,,,,,,,,
HAPTOGLOBIN,3001625,CDM,83010,CPT,Facility,both,,,,122,61,,,,,,,,,,,,
SIROLIMUS,3001627,CDM,80195,CPT,Facility,both,,,,292,146,,,,,,,,,,,,
UA DIPSTICK AUTO W/O MICRO,3001628,CDM,81003,CPT,Facility,both,,,,137,68.5,,,,,,,,,,,,
CALCULUS ANALYSIS SPECTROSCOPY,3001632,CDM,82365,CPT,Facility,both,,,,108,54,,,,,,,,,,,,
ESTRONE,3001638,CDM,82679,CPT,Facility,both,,,,80,40,,,,,,,,,,,,
RBC FOLATE,3001639,CDM,82747,CPT,Facility,both,,,,75,37.5,,,,,,,,,,,,
EBV BY PCR,3001641,CDM,87799,CPT,Facility,both,,,,756,378,,,,,,,,,,,,
"G6PD, QUANTITATIVE",3001642,CDM,82955,CPT,Facility,both,,,,120,60,,,,,,,,,,,,
"BX, SURG PATH LEVEL IV",3001645,CDM,88305,CPT,Facility,both,,,,205,102.5,,,,,,,,,,,,
VITAMIN B6,3001653,CDM,84207,CPT,Facility,both,,,,196,98,,,,,,,,,,,,
TRICHROME STAIN,3001655,CDM,87209,CPT,Facility,both,,,,62,31,,,,,,,,,,,,
ANAEROBE ID,3001663,CDM,87076,CPT,Facility,both,,,,109,54.5,,,,,,,,,,,,
CULTURE ANAEROBIC,3001664,CDM,87075,CPT,Facility,both,,,,140,70,,,,,,,,,,,,
Incisional biopsy of skin,3001666,CDM,11106,CPT,Facility,both,,,,654,327,,,,,,,,,,,,
HIV CONFIRMATION,3001668,CDM,86689,CPT,Facility,both,,,,135,67.5,,,,,,,,,,,,
HERPES SIMPLEX TYPE 1,3001670,CDM,86695,CPT,Facility,both,,,,150,75,,,,,,,,,,,,
HERPES SIMPLEX TYPE 2,3001671,CDM,86696,CPT,Facility,both,,,,150,75,,,,,,,,,,,,
HIV 1/2 ANTIBODY,3001673,CDM,86703,CPT,Facility,both,,,,56,28,,,,,,,,,,,,
"HEPATITIS B CORE AB, IGM",3001675,CDM,86705,CPT,Facility,both,,,,270,135,,,,,,,,,,,,
ORGANISM ID,3001692,CDM,87077,CPT,Facility,both,,,,85,42.5,,,,,,,,,,,,
GIARDIA,3001706,CDM,87329,CPT,Facility,both,,,,113,56.5,,,,,,,,,,,,
ZARONTIN (ETHOSUXIMIDE),3001761,CDM,80168,CPT,Facility,both,,,,184,92,,,,,,,,,,,,
PRIMIDONE (MYSOLINE),3001763,CDM,80188,CPT,Facility,both,,,,164,82,,,,,,,,,,,,
LAMOTRIGINE (LAMICTAL),3001772,CDM,80175,CPT,Facility,both,,,,175,87.5,,,,,,,,,,,,
"GABAPENTIN WHOLE BLOOD, SERUM,",3001778,CDM,80171,CPT,Facility,both,,,,206,103,,,,,,,,,,,,
CYSTINE,3001787,CDM,82131,CPT,Facility,both,,,,91,45.5,,,,,,,,,,,,
APOLIPOPROTEIN,3001788,CDM,82172,CPT,Facility,both,,,,75,37.5,,,,,,,,,,,,
ARSENIC (URINE),3001789,CDM,82175,CPT,Facility,both,,,,88,44,,,,,,,,,,,,
VITAMIN C,3001790,CDM,82180,CPT,Facility,both,,,,79,39.5,,,,,,,,,,,,
CADMIUM (BLOOD),3001791,CDM,82300,CPT,Facility,both,,,,75,37.5,,,,,,,,,,,,
CALCITONIN,3001792,CDM,82308,CPT,Facility,both,,,,190,95,,,,,,,,,,,,
CERULOPLASMIN,3001794,CDM,82390,CPT,Facility,both,,,,117,58.5,,,,,,,,,,,,
SERUM FREE LIGHT CHAINS,3001795,CDM,82664,CPT,Facility,both,,,,154,77,,,,,,,,,,,,
"COMPLEMENT, C4",3001797,CDM,86160,CPT,Facility,both,,,,125,62.5,,,,,,,,,,,,
"COMPLEMENT, C3",3001798,CDM,86160,CPT,Facility,both,,,,125,62.5,,,,,,,,,,,,
COMP C1 ESTERASE INHIBITOR,3001799,CDM,86160,CPT,Facility,both,,,,125,62.5,,,,,,,,,,,,
"IMMUNOELECTROPHORESIS, SERUM",3001814,CDM,86320,CPT,Facility,both,,,,140,70,,,,,,,,,,,,
"INSULIN AB, BEEF",3001815,CDM,86337,CPT,Facility,both,,,,208,104,,,,,,,,,,,,
"INSULIN AB, HUMAN",3001816,CDM,86337,CPT,Facility,both,,,,208,104,,,,,,,,,,,,
"INSULIN AB, PORK",3001817,CDM,86337,CPT,Facility,both,,,,208,104,,,,,,,,,,,,
INTRINSIC FACTOR ANTIBODIES,3001818,CDM,86340,CPT,Facility,both,,,,112,56,,,,,,,,,,,,
T CELLS (TOTAL),3001820,CDM,86359,CPT,Facility,both,,,,164,82,,,,,,,,,,,,
BACTERIAL AG (H.FLU),3001823,CDM,86403,CPT,Facility,both,,,,85,42.5,,,,,,,,,,,,
BACTERIAL AG (N. MEN),3001824,CDM,86403,CPT,Facility,both,,,,85,42.5,,,,,,,,,,,,
BACTERIAL AG (S.PNEU),3001825,CDM,86403,CPT,Facility,both,,,,85,42.5,,,,,,,,,,,,
"RPR TITER, QUANTITATIVE",3001827,CDM,86593,CPT,Facility,both,,,,22,11,,,,,,,,,,,,
ADENOVIRUS AB (QUANTITATIVE,3001828,CDM,86603,CPT,Facility,both,,,,22,11,,,,,,,,,,,,
LYME DISEASE AB TOTAL,3001830,CDM,86618,CPT,Facility,both,,,,43,21.5,,,,,,,,,,,,
"CHLAMYDIA PSITTACI, IgM",3001831,CDM,86632,CPT,Facility,both,,,,70,35,,,,,,,,,,,,
COCCIDIOIDES AB,3001832,CDM,86635,CPT,Facility,both,,,,200,100,,,,,,,,,,,,
"EPSTEIN-BARR VIRUS, VCA, IgG",3001833,CDM,86665,CPT,Facility,both,,,,121,60.5,,,,,,,,,,,,
"EPSTEIN-BARR VIRUS, VCA, IgM",3001834,CDM,86665,CPT,Facility,both,,,,121,60.5,,,,,,,,,,,,
VARICELLA AB IGG,3001835,CDM,86787,CPT,Facility,both,,,,121,60.5,,,,,,,,,,,,
VARICELLA AB IGM,3001836,CDM,86787,CPT,Facility,both,,,,121,60.5,,,,,,,,,,,,
MICROSPORIDIA SPORE DETECTION,3001846,CDM,87207,CPT,Facility,both,,,,115,57.5,,,,,,,,,,,,
VASOPRESSIN (ADH),3001868,CDM,84588,CPT,Facility,both,,,,215,107.5,,,,,,,,,,,,
"DEOXYRIBONUCLEASE, ANTIBODY",3001870,CDM,86215,CPT,Facility,both,,,,65,32.5,,,,,,,,,,,,
HEMOGLOBIN ELECTROPHORESIS,3001886,CDM,83020,CPT,Facility,both,,,,145,72.5,,,,,,,,,,,,
LEVETIRACETAM (KEPPRA),3001893,CDM,80177,CPT,Facility,both,,,,163,81.5,,,,,,,,,,,,
VANCOMYCIN TROUGH,3001895,CDM,80202,CPT,Facility,both,,,,184,92,,,,,,,,,,,,
"IMMUNOGLOBULIN IGA, TOTAL",3001914,CDM,82784,CPT,Facility,both,,,,75,37.5,,,,,,,,,,,,
"IMMUNOGLOBULIN IGG, TOTAL",3001915,CDM,82784,CPT,Facility,both,,,,75,37.5,,,,,,,,,,,,
IGM IMMUNOGLOBULIN,3001916,CDM,82784,CPT,Facility,both,,,,75,37.5,,,,,,,,,,,,
CHROMOGRANIN A,3001930,CDM,86316,CPT,Facility,both,,,,265,132.5,,,,,,,,,,,,
CADMIUM URINE,3001941,CDM,82300,CPT,Facility,both,,,,75,37.5,,,,,,,,,,,,
CMV DNA BY PCR,3001947,CDM,87497,CPT,Facility,both,,,,350,175,,,,,,,,,,,,
ISLET CELL ANTIBODY,3001950,CDM,86341,CPT,Facility,both,,,,175,87.5,,,,,,,,,,,,
B-12 BINDING CAPACITY UNSAT,3001956,CDM,82608,CPT,Facility,both,,,,240,120,,,,,,,,,,,,
"ANTIDEPRE, NOS",3001981,CDM,80338,CPT,Facility,both,,,,21,10.5,,,,,,,,,,,,
RBC SICKLE CELL SCREEN,3001998,CDM,85660,CPT,Facility,both,,,,71,35.5,,,,,,,,,,,,
ANTIPSYCHOTICS; 4-6,3002029,CDM,80343,CPT,Facility,both,,,,132,66,,,,,,,,,,,,
ASPERGILUS IGM,3002034,CDM,86606,CPT,Facility,both,,,,88,44,,,,,,,,,,,,
ANTIBODY TREPONEMA PALLDIUM,3002036,CDM,86780,CPT,Facility,both,,,,20,10,,,,,,,,,,,,
COPPER ASSAY,3002037,CDM,82525,CPT,Facility,both,,,,69,34.5,,,,,,,,,,,,
EPSTEIN-BAR (EBV) QUANT (PCR),3002038,CDM,87480, CPT,Facility,outpatient,,,,171.36,85.68,,,,,,,,,,,,
"LEAD, URINE",3002046,CDM,83655,CPT,Facility,both,,,,95,47.5,,,,,,,,,,,,
OSTEOCALCIN,3002054,CDM,83937,CPT,Facility,both,,,,1255,627.5,,,,,,,,,,,,
HEP B VIRAL DNA,3002081,CDM,87517,CPT,Facility,both,,,,373,186.5,,,,,,,,,,,,
"STIMULANTS, SYNTHETIC",3002090,CDM,80371,CPT,Facility,both,,,,243,121.5,,,,,,,,,,,,
17 OH PREGNENOLONE,3002093,CDM,84143,CPT,Facility,both,,,,137,68.5,,,,,,,,,,,,
PROTEIN WESTERN BLOT,3002096,CDM,84181,CPT,Facility,both,,,,104,52,,,,,,,,,,,,
"ANALGESICS, NON-OP, 1 OR 2",3002128,CDM,80305, CPT,Facility,outpatient,,,,206,103,,,,,,,,,,,,
FINE NDLE ASPIRATE INTRP,3002144,CDM,88173,CPT,Facility,both,,,,156,78,,,,,,,,,,,,
SP LEVEL II GROSS MICRO,3002147,CDM,88302,CPT,Facility,both,,,,102,51,,,,,,,,,,,,
SP LEVEL III GROSS MICRO,3002148,CDM,88304,CPT,Facility,both,,,,144,72,,,,,,,,,,,,
SP LEVEL V GROSS MICRO,3002149,CDM,88307,CPT,Facility,both,,,,144,72,,,,,,,,,,,,
SP SPEC STAIN GROUP I EA,3002152,CDM,88312,CPT,Facility,both,,,,141,70.5,,,,,,,,,,,,
SP CHEMICAL HISTOCHEMISTRY,3002154,CDM,88313,CPT,Facility,both,,,,141,70.5,,,,,,,,,,,,
SP IMMUNOCHEM- INITIAL SNGL AB,3002162,CDM,88342,CPT,Facility,both,,,,205,102.5,,,,,,,,,,,,
ELECTROLYTES PANEL,3002178,CDM,80051,CPT,Facility,both,,,,140,70,,,,,,,,,,,,
Total CK  repeat,3002200,CDM,82553,CPT,Facility,both,,,,199,99.5,,,,,,,,,,,,
Troponin Repeat,3002201,CDM,84484,CPT,Facility,both,,,,230,115,,,,,,,,,,,,
CK-MB Report,3002202,CDM,82550,CPT,Facility,both,,,,148,74,,,,,,,,,,,,
SODIUM URINE,3002215,CDM,84300,CPT,Facility,both,,,,55,27.5,,,,,,,,,,,,
TOBRAMYCIN PEAK,3002233,CDM,80200,CPT,Facility,both,,,,175,87.5,,,,,,,,,,,,
TOBRAMYCIN TROUGH,3002234,CDM,80200,CPT,Facility,both,,,,175,87.5,,,,,,,,,,,,
AG EIA QL/SQ LEGIONELLA UR,3002237,CDM,87449,CPT,Facility,both,,,,115,57.5,,,,,,,,,,,,
AG PAT TESTING INDIRECT QU,3002243,CDM,86885,CPT,Facility,both,,,,48,24,,,,,,,,,,,,
INSULIN FREE,3002261,CDM,83527,CPT,Facility,both,,,,150,75,,,,,,,,,,,,
TESTOSTERONE FREE,3002267,CDM,84402,CPT,Facility,both,,,,189,94.5,,,,,,,,,,,,
"THIAMINE, VIT B1",3002268,CDM,84425,CPT,Facility,both,,,,172,86,,,,,,,,,,,,
VITAMIN D; 25 HYDROXY W/FRACT,3002270,CDM,82306,CPT,Facility,both,,,,290,145,,,,,,,,,,,,
FREE KAPPA - NEPHELOMETRY,3002273,CDM,83883,CPT,Facility,both,,,,170,85,,,,,,,,,,,,
CELL SURF MARKER ADD,3002275,CDM,88185,CPT,Facility,both,,,,110,55,,,,,,,,,,,,
IMMUNOFIX URINE,3002287,CDM,86335,CPT,Facility,both,,,,165,82.5,,,,,,,,,,,,
"H. PYLORI, STOOL",3002302,CDM,87338,CPT,Facility,both,,,,145,72.5,,,,,,,,,,,,
NMR LIPO PROFILE,3002303,CDM,83704,CPT,Facility,both,,,,335,167.5,,,,,,,,,,,,
"ROCKY MTN SPD FEVER, IgG",3002307,CDM,86757,CPT,Facility,both,,,,125,62.5,,,,,,,,,,,,
HEPATITIS DELTA AGENT,3002330,CDM,86692,CPT,Facility,both,,,,100,50,,,,,,,,,,,,
QUANTIFERON TB GOLD,3002338,CDM,86480,CPT,Facility,both,,,,160,80,,,,,,,,,,,,
CHEMILUMINESCENT ASSAY,3002350,CDM,82397,CPT,Facility,both,,,,180,90,,,,,,,,,,,,
SEX HORMONE BINDING GLOBULIN,3002362,CDM,84270,CPT,Facility,both,,,,145,72.5,,,,,,,,,,,,
ANTICARDIOLIPIN AB IGA/G/M QN,3002372,CDM,86147,CPT,Facility,both,,,,152,76,,,,,,,,,,,,
"H. PYLORI IGG, ABS",3002374,CDM,86677,CPT,Facility,both,,,,170,85,,,,,,,,,,,,
HCV RNA PCR,3002375,CDM,87522,CPT,Facility,both,,,,450,225,,,,,,,,,,,,
"LEAD, BLOOD (PEDIATRIC)",3002378,CDM,83655,CPT,Facility,both,,,,95,47.5,,,,,,,,,,,,
"H. PYLORI, IGM/G,A AB",3002381,CDM,86677,CPT,Facility,both,,,,170,85,,,,,,,,,,,,
OXCARBAZEPINE LEVEL,3002413,CDM,80183,CPT,Facility,both,,,,53,26.5,,,,,,,,,,,,
MYCOPHENOLIC ACID AND ME,3002414,CDM,80307, CPT,Facility,outpatient,,,,96.36,48.18,,,,,,,,,,,,
COLUMN CHROMOTOGRAPHY QUANT,3002420,CDM,82542,CPT,Facility,both,,,,356,178,,,,,,,,,,,,
PANCREATIC ELASTASE,3002424,CDM,82653,CPT,Facility,outpatient,,,,245,122.5,,,,,,,,,,,,
MTHFR,3002428,CDM,81291,CPT,Facility,both,,,,442,221,,,,,,,,,,,,
LACTATE (LD) (LDH) ENZYME,3002452,CDM,83615, CPT,Facility,outpatient,,,,88,44,,,,,,,,,,,,
GLUCOSE BODY FLUID,3002453,CDM,82945,CPT,Facility,both,,,,80,40,,,,,,,,,,,,
CHROMIUM,3002485,CDM,82495,CPT,Facility,both,,,,150,75,,,,,,,,,,,,
F2 GENE 20210G>A VARIANT,3002523,CDM,81240,CPT,Facility,both,,,,726,363,,,,,,,,,,,,
"UREA NITROGEN, URINE",3002538,CDM,84540,CPT,Facility,both,,,,58,29,,,,,,,,,,,,
TRIIODOTHYRONINE T3 REVERSE,3002560,CDM,84482,CPT,Facility,both,,,,75,37.5,,,,,,,,,,,,
PHENYTOIN;FREE,3002565,CDM,80186,CPT,Facility,both,,,,162,81,,,,,,,,,,,,
BLD TYPING; AG SCRN W/ PTSERUM,3002566,CDM,86904,CPT,Facility,both,,,,75,37.5,,,,,,,,,,,,
PNEUMOCYSTIS JIROVECII TIV,3002569,CDM,87798,CPT,Facility,both,,,,520,260,,,,,,,,,,,,
MANGANESE,3002570,CDM,83785,CPT,Facility,both,,,,183,91.5,,,,,,,,,,,,
SELENIUM,3002571,CDM,84255,CPT,Facility,both,,,,125,62.5,,,,,,,,,,,,
"MOLECULAR PATH PROC, L II",3002574,CDM,81401,CPT,Facility,both,,,,648,324,,,,,,,,,,,,
SODIUM OTHER SOURCE,3002581,CDM,84302,CPT,Facility,both,,,,75,37.5,,,,,,,,,,,,
CAFFEINE,3002605,CDM,80155,CPT,Facility,both,,,,114,57,,,,,,,,,,,,
TYROSINE,3002616,CDM,84510,CPT,Facility,both,,,,83,41.5,,,,,,,,,,,,
"DIPHTHERIA ANTIBODY, TITER",3002620,CDM,86648,CPT,Facility,both,,,,95,47.5,,,,,,,,,,,,
URINE MICROALBUMIN QUANT,3002630,CDM,82043,CPT,Facility,both,,,,85,42.5,,,,,,,,,,,,
DRUG TEST DIRECT OPTICAL OBS,3002716,CDM,80305,CPT,Facility,outpatient,,,,170,85,,,,,,,,,,,,
DRUG TEST INSTRUMENT ANALYZER,3002718,CDM,80307,CPT,Facility,outpatient,,,,170,85,,,,,,,,,,,,
ZZ URINE DIPSTICK ONLY RHC,3020007,CDM,81001, CPT,Facility,outpatient,,,,13.92,6.96,,,,,,,,,,,,
COVID-19 TESTING (PCR),3020008,CDM,87635,CPT,Facility,both,,,,181,90.5,,,,,,,,,,,,
"GALACTOSE-ALPHA-1,3",3020018,CDM,82945, CPT,Facility,outpatient,,,,31.28,15.64,,,,,,,,,,,,
BUPRENORPHINE,3020026,CDM,80348,CPT,Facility,outpatient,,,,4,2,,,,,,,,,,,,
MDMA,3020027,CDM,80359,CPT,Facility,both,,,,4,2,,,,,,,,,,,,
HEROIN (6-MAM),3020028,CDM,80356,CPT,Facility,both,,,,4,2,,,,,,,,,,,,
"ANTIDEPRES, CYCLICALS; 3-5",3020029,CDM,80336,CPT,Facility,both,,,,370,185,,,,,,,,,,,,
TAPENTADOL,3020030,CDM,80372,CPT,Facility,both,,,,4,2,,,,,,,,,,,,
"GABAPENTIN,",3020031,CDM,80355,CPT,Facility,both,,,,4,2,,,,,,,,,,,,
PREGABALIN,3020032,CDM,80366,CPT,Facility,both,,,,4,2,,,,,,,,,,,,
SKELETAL MUSCLE REL; 1 OR 2,3020033,CDM,80369,CPT,Facility,both,,,,100,50,,,,,,,,,,,,
FENTANYL,3020034,CDM,80354,CPT,Facility,both,,,,4,2,,,,,,,,,,,,
METHYLPHENIDATE,3020035,CDM,80360,CPT,Facility,both,,,,4,2,,,,,,,,,,,,
SEDATIVE HYPNOTICS,3020036,CDM,80368,CPT,Facility,both,,,,4,2,,,,,,,,,,,,
TRAMADOL,3020037,CDM,80373,CPT,Facility,both,,,,4,2,,,,,,,,,,,,
"ANTIDEPRET,SEROTONERGIC class 1 or 2",3020038,CDM,80332,CPT,Facility,both,,,,109,54.5,,,,,,,,,,,,
"ANTIDEPR, SEROTONERGIC class 3 - 5",3020039,CDM,80333,CPT,Facility,both,,,,4,2,,,,,,,,,,,,
ANABOLIC STEROID; 1 OR 2,3020047,CDM,80327,CPT,Facility,both,,,,218,109,,,,,,,,,,,,
Bx/Ex LmphNds Ndl Sprfcl 38505,3034314,CDM,38505,CPT,Facility,inpatient,,,,98,49,,,,,,,,,,,,
PH STOOL,3099019,CDM,83986,CPT,Facility,both,,,,37,18.5,,,,,,,,,,,,
US Guid for Needle Placm 76942,3882345,CDM,76942,CPT,Facility,both,,,,551,275.5,,,,,,,,,,,,
Asp/Inj Joint Small 20600,3940350,CDM,20600,CPT,Facility,both,,,,1334.15,667.08,,,,,,,,,,,,
Asp/Inj Joint Lg w/o US 20610,3940351,CDM,20610,CPT,Facility,both,,,,892,446,,,,,,,,,,,,
ABG ANALYSIS,4001001,CDM,82803,CPT,Facility,both,,,,150,75,,,,,,,,,,,,
ARTERIAL PUNCTURE,4001002,CDM,36600,CPT,Facility,both,,,,138,69,,,,,,,,,,,,
CHEST PT/PDP INIT,4001007,CDM,94667,CPT,Facility,outpatient,,,,150,75,,,,,,,,,,,,
CHEST PT/PDP SUB,4001008,CDM,94668,CPT,Facility,outpatient,,,,322,161,,,,,,,,,,,,
CPAP/BIPAP-INITIAL/MGMT,4001009,CDM,94660,CPT,Facility,outpatient,,,,277,138.5,,,,,,,,,,,,
CROUPETTE  INITIAL,4001010,CDM,94799,CPT,Facility,outpatient,,,,304,152,,,,,,,,,,,,
CROUPETTE  SUBSEQUEN,4001011,CDM,94799,CPT,Facility,outpatient,,,,322,161,,,,,,,,,,,,
EEG,4001014,CDM,95819,CPT,Facility,both,,,,322,161,,,,,,,,,,,,
CPR,4001018,CDM,92950,CPT,Facility,both,,,,150,75,,,,,,,,,,,,
SPUTUM SPECIMEN COLLECTION,4001030,CDM,89220,CPT,Facility,both,,,,201,100.5,,,,,,,,,,,,
VENT INITIAL-DAY,4001033,CDM,94002,CPT,Facility,both,,,,150,75,,,,,,,,,,,,
VENT SUBSEQUENT DAY,4001034,CDM,94003,CPT,Facility,both,,,,260,130,,,,,,,,,,,,
NT SUCTION ASPIRATION REMOVAL,4001056,CDM,31720,CPT,Facility,both,,,,277,138.5,,,,,,,,,,,,
OVERNIGHT PULSE OX STUDY,4001091,CDM,94762,CPT,Facility,outpatient,,,,260,130,,,,,,,,,,,,
R.C. INTUBATION,4001102,CDM,31500,CPT,Facility,both,,,,864.28,432.14,,,,,,,,,,,,
BRONCHODILATOR METHAC PRE/POST,4001133,CDM,94070,CPT,Facility,both,,,,1081.16,540.58,,,,,,,,,,,,
SPCO SPOT CHECK,4001138,CDM,88740,CPT,Facility,both,,,,110,55,,,,,,,,,,,,
TRACHEOSTOMY CARE,4001150,CDM,31899,CPT,Facility,both,,,,277,138.5,,,,,,,,,,,,
ASTHMA ASSESSMENT,4001160,CDM,96160,CPT,Facility,both,,,,107.36,53.68,,,,,,,,,,,,
PULMONARY STRESS TEST,4001199,CDM,94618,CPT,Facility,both,,,,460.64,230.32,,,,,,,,,,,,
Lumbar Puncture 62270,4092346,CDM,62270,CPT,Facility,inpatient,,,,848,424,,,,,,,,,,,,
97140-PHYS THERMANTHERAPY /15 MIN,4101002,CDM,97140,CPT,Facility,both,,,,90,45,,,,,,,,,,,,
PT ELEC STIM/MAN/15 MIN,4101005,CDM,97032,CPT,Facility,both,,,,117,58.5,,,,,,,,,,,,
PT E.STIM UNATTENDED,4101006,CDM,G0283,HCPCS,Facility,both,,,,98,49,,,,,,,,,,,,
PT GAIT TRAINING/15 MIN,4101007,CDM,97116,CPT,Facility,both,,,,90,45,,,,,,,,,,,,
PT HOT/COLD PACKS,4101008,CDM,97010,CPT,Facility,both,,,,39,19.5,,,,,,,,,,,,
PT IONTOPHORESIS/15 MIN,4101009,CDM,97033,CPT,Facility,both,,,,140,70,,,,,,,,,,,,
PT MANUAL THRPY/30 MIN,4101010,CDM,97140,CPT,Facility,both,,,,180,90,,,,,,,,,,,,
PT MASSGE THRPY/15 MIN,4101011,CDM,97124,CPT,Facility,both,,,,90,45,,,,,,,,,,,,
PT MECH TRACTION/VISIT,4101012,CDM,97012,CPT,Facility,both,,,,99,49.5,,,,,,,,,,,,
PT NEURO RE-ED/15 MIN,4101014,CDM,97112,CPT,Facility,both,,,,146,73,,,,,,,,,,,,
PHYS THER EVAL MOD COMP 30 MN,4101015,CDM,97162,CPT,Facility,both,,,,304,152,,,,,,,,,,,,
PT PARAFIN BATH/VISIT,4101016,CDM,97018,CPT,Facility,both,,,,94,47,,,,,,,,,,,,
PHYS THER EVAL HIGH COMP 45 MN,4101017,CDM,97163,CPT,Facility,both,,,,322,161,,,,,,,,,,,,
PHYS THER REEVAL PLAN 20 MN,4101018,CDM,97164,CPT,Facility,both,,,,150,75,,,,,,,,,,,,
PT ROM MEASURE EXT,4101020,CDM,95851,CPT,Facility,both,,,,99,49.5,,,,,,,,,,,,
PT SELF CARE MGT/15 MIN,4101021,CDM,97535,CPT,Facility,both,,,,105,52.5,,,,,,,,,,,,
PT THER ACTS 1 ON 1/15 MIN,4101022,CDM,97530,CPT,Facility,both,,,,140,70,,,,,,,,,,,,
PT THERAPY EXER/15 MIN,4101023,CDM,97110,CPT,Facility,both,,,,140,70,,,,,,,,,,,,
PT ULTRASOUND/15 MIN,4101024,CDM,97035,CPT,Facility,both,,,,101,50.5,,,,,,,,,,,,
PT VASPNEUMATIC DEV/VIS,4101026,CDM,97016,CPT,Facility,both,,,,60,30,,,,,,,,,,,,
PT WHEELCHR MGT/15 MIN,4101027,CDM,97542,CPT,Facility,both,,,,111,55.5,,,,,,,,,,,,
PT WHIRLPOOL THRPY/VIST,4101028,CDM,97022,CPT,Facility,both,,,,136,68,,,,,,,,,,,,
PT WORK HARDEN/COND EA ADDL HR,4101032,CDM,97546,CPT,Facility,both,,,,117,58.5,,,,,,,,,,,,
PT DEBRID/ASSESS 1ST 20 SQ CM,4101037,CDM,97597,CPT,Facility,both,,,,297,148.5,,,,,,,,,,,,
PT PHYS PERFORMANCE TEST/15MIN,4101041,CDM,97750,CPT,Facility,both,,,,143,71.5,,,,,,,,,,,,
PT COM/WORK REINTEGRATE/15 MIN,4101047,CDM,97537,CPT,Facility,both,,,,105,52.5,,,,,,,,,,,,
PT WORK HARDEN/COND 1ST 2HR,4101048,CDM,97545,CPT,Facility,both,,,,163,81.5,,,,,,,,,,,,
PT APPLICATION OF UNA BOOT,4101069,CDM,29580,CPT,Facility,both,,,,168,84,,,,,,,,,,,,
PT PROSTH TRAIN/15 MIN,4101070,CDM,97761,CPT,Facility,both,,,,118,59,,,,,,,,,,,,
PT EVAL/VISIT LOW,4101106,CDM,97161,CPT,Facility,both,,,,227,113.5,,,,,,,,,,,,
PT EVAL/VISIT MODERATE,4101107,CDM,97162,CPT,Facility,both,,,,304,152,,,,,,,,,,,,
PT EVAL/VISIT HIGH,4101108,CDM,97163,CPT,Facility,both,,,,322,161,,,,,,,,,,,,
PT RE-EVAL/VISIT,4101113,CDM,97164,CPT,Facility,both,,,,150,75,,,,,,,,,,,,
Drain Ext Ear lesion smp 69000,4185345,CDM,69000,CPT,Facility,both,,,,730.84,365.42,,,,,,,,,,,,
Rem FB Intranasal Ofprc 30300,4185354,CDM,30300,CPT,Facility,both,,,,484.04,242.02,,,,,,,,,,,,
I&D Wound Infection 10180,4185360,CDM,10180,CPT,Facility,both,,,,3890,1945,,,,,,,,,,,,
Aspirate Pleura w/o Imag 32554,4192024,CDM,32554,CPT,Facility,inpatient,,,,322,161,,,,,,,,,,,,
Insrt Cath Pleur w/o Img 32556,4192025,CDM,32556,CPT,Facility,both,,,,2975.92,1487.96,,,,,,,,,,,,
Drs/dbr Prt Thk Brn <5%BS16020,4195730,CDM,16020,CPT,Facility,both,,,,442,221,,,,,,,,,,,,
PHYS THER EVAL LOW COMP 20 MIN,4201003,CDM,97161,CPT,Facility,both,,,,227,113.5,,,,,,,,,,,,
OT ROM MEASURE EXT,4201004,CDM,95851,CPT,Facility,both,,,,99,49.5,,,,,,,,,,,,
OT ELECT STIM MAN 15MIN,4201006,CDM,97032,CPT,Facility,both,,,,117,58.5,,,,,,,,,,,,
OT IONTOPHORESIS/15 MIN,4201007,CDM,97033,CPT,Facility,both,,,,140,70,,,,,,,,,,,,
OT CONTRAST BATH/15 MIN,4201008,CDM,97034,CPT,Facility,both,,,,90,45,,,,,,,,,,,,
OT THERAPY EXER/15 MIN,4201009,CDM,97110,CPT,Facility,both,,,,140,70,,,,,,,,,,,,
OT NEURO RE-ED/15 MIN,4201010,CDM,97112,CPT,Facility,both,,,,146,73,,,,,,,,,,,,
OT GAIT TRAINING/15 MIN,4201011,CDM,97116,CPT,Facility,both,,,,117,58.5,,,,,,,,,,,,
OT MASSGE THRPY/15 MIN,4201012,CDM,97124,CPT,Facility,both,,,,121,60.5,,,,,,,,,,,,
OT MANUAL THRPY/15 MIN,4201013,CDM,97140,CPT,Facility,both,,,,121,60.5,,,,,,,,,,,,
OT THER ACTIS 1 ON 1/15 MIN,4201014,CDM,97530,CPT,Facility,both,,,,140,70,,,,,,,,,,,,
OT WHEELCHAIR MGMT,4201015,CDM,97542,CPT,Facility,both,,,,111,55.5,,,,,,,,,,,,
OT SELF CARE MGT/15 MIN,4201016,CDM,97535,CPT,Facility,both,,,,105,52.5,,,,,,,,,,,,
OT MECH TRACTION/VISIT,4201017,CDM,97012,CPT,Facility,both,,,,99,49.5,,,,,,,,,,,,
OT VASOPNEUM DEV,4201018,CDM,97016,CPT,Facility,both,,,,60,30,,,,,,,,,,,,
OT PARAFIN BATH,4201019,CDM,97018,CPT,Facility,both,,,,94,47,,,,,,,,,,,,
OT ICE/HOT PACK,4201020,CDM,97010,CPT,Facility,both,,,,139,69.5,,,,,,,,,,,,
OT COMM/WORK REINE/15 MIN,4201021,CDM,97537,CPT,Facility,both,,,,105,52.5,,,,,,,,,,,,
OT E.STIM UNATTENDED,4201022,CDM,97014,CPT,Facility,both,,,,99,49.5,,,,,,,,,,,,
PHYS THER EVAL MOD COMP 30 MIN,4201023,CDM,97162,CPT,Facility,both,,,,304,152,,,,,,,,,,,,
PHYS THER EVAL HIGH COMP 45 MN,4201024,CDM,97163,CPT,Facility,both,,,,322,161,,,,,,,,,,,,
PHYS THER REEVAL PLAN 20 MN,4201025,CDM,97164,CPT,Facility,both,,,,150,75,,,,,,,,,,,,
OT ROM HAND,4201026,CDM,95852,CPT,Facility,both,,,,116,58,,,,,,,,,,,,
OT PHYS PERFOR TEST/15MIN,4201027,CDM,97750,CPT,Facility,both,,,,143,71.5,,,,,,,,,,,,
OT EVAL/VISIT LOW,4201055,CDM,97165,CPT,Facility,both,,,,277,138.5,,,,,,,,,,,,
OT EVAL/VISIT MODERATE,4201056,CDM,97166,CPT,Facility,both,,,,304,152,,,,,,,,,,,,
OT EVAL/VISIT HIGH,4201057,CDM,97167,CPT,Facility,both,,,,322,161,,,,,,,,,,,,
OT RE-EVAL/VISIT,4201058,CDM,97168,CPT,Facility,both,,,,322,161,,,,,,,,,,,,
OCC THER EVAL LOW COMP 30 MINS,4201059,CDM,97165,CPT,Facility,both,,,,277,138.5,,,,,,,,,,,,
OCC THER EVAL MOD COMP 45 MINS,4201060,CDM,97166,CPT,Facility,both,,,,304,152,,,,,,,,,,,,
OCC THER EVAL HIGH COMP 60 MN,4201061,CDM,97167,CPT,Facility,both,,,,322,161,,,,,,,,,,,,
OCC THER REEVAL EST PLAN 30 MN,4201062,CDM,97168,CPT,Facility,both,,,,322,161,,,,,,,,,,,,
ATH TRN EVAL LOW COMP 15 MINS,4201063,CDM,97169,CPT,Facility,both,,,,260,130,,,,,,,,,,,,
ATH TRN EVAL MOD COMP 30 MINS,4201064,CDM,97170,CPT,Facility,both,,,,260,130,,,,,,,,,,,,
ATH TRN EVAL HIGH COMP 45 MINS,4201065,CDM,97171,CPT,Facility,both,,,,260,130,,,,,,,,,,,,
ATHC TRAIN REEVAL EST 20 MINS,4201066,CDM,97172,CPT,Facility,both,,,,260,130,,,,,,,,,,,,
Fam Psych w/oPatient PHD 90846,4299060,CDM,90846,CPT,Facility,both,,,,387.4,193.7,,,,,,,,,,,,
SPT Therapeutic Inter,4300001,CDM,97129,CPT,Facility,both,,,,209,104.5,,,,,,,,,,,,
ST SENSOR INT TECH IND/15MIN,4300007,CDM,97533,CPT,Facility,both,,,,312,156,,,,,,,,,,,,
ST EVAL ORAL/PHAR SWALLOW FUNC,4301001,CDM,92610,CPT,Facility,both,,,,318,159,,,,,,,,,,,,
ST TX SP/LANG VOICE DISORDER,4301003,CDM,92507,CPT,Facility,both,,,,363,181.5,,,,,,,,,,,,
ST TX ORAL FUNCTION THERAPY,4301006,CDM,92526,CPT,Facility,both,,,,293,146.5,,,,,,,,,,,,
ST ASSESS APHASIA PER HR,4301007,CDM,96105,CPT,Facility,both,,,,351,175.5,,,,,,,,,,,,
ST FLEX ENDO SWALLOWING EVAL,4301008,CDM,92612,CPT,Facility,both,,,,410,205,,,,,,,,,,,,
ST EVAL OF SPEECH FLUENCY,4301035,CDM,92521,CPT,Facility,both,,,,239,119.5,,,,,,,,,,,,
ST EVALUATE SPEECH PRODUCTION,4301036,CDM,92522,CPT,Facility,both,,,,193,96.5,,,,,,,,,,,,
ST SPEECH SOUND LANG COMP,4301037,CDM,92523,CPT,Facility,both,,,,193,96.5,,,,,,,,,,,,
ST BEH QUAL ANALYSIS VOICE,4301038,CDM,92524,CPT,Facility,both,,,,363,181.5,,,,,,,,,,,,
TLHTH PT EVAL/VISIT LOW,4401000,CDM,97161,CPT,Facility,both,,,,227,113.5,,,,,,,,,,,,
TLHTH PT EVAL/VISIT MOD,4401001,CDM,97162,CPT,Facility,both,,,,304,152,,,,,,,,,,,,
TLHLT PT EVAL/VISIT HIGH,4401002,CDM,97163,CPT,Facility,both,,,,322,161,,,,,,,,,,,,
TLHTH OCC THR EVAL LOW 30 MINS,4401003,CDM,97165,CPT,Facility,both,,,,304,152,,,,,,,,,,,,
TLHTH OCC THER EVAL MOD 45 MIN,4401004,CDM,97166,CPT,Facility,both,,,,304,152,,,,,,,,,,,,
TLHTH OCC THER EVAL HI 60 MIN,4401005,CDM,97167,CPT,Facility,both,,,,322,161,,,,,,,,,,,,
TLHTH ST SPCH SOUND LANG COMP,4401006,CDM,92523,CPT,Facility,both,,,,193,96.5,,,,,,,,,,,,
TLHTH ST EVAL SPEECH PROD,4401007,CDM,92522,CPT,Facility,both,,,,193,96.5,,,,,,,,,,,,
TLHTH ST EVAL ORL SWL FUNC,4401008,CDM,92610,CPT,Facility,both,,,,318,159,,,,,,,,,,,,
Venipuncture by MA/Nurse 36415,4609984,CDM,36415,CPT,Facility,both,,,,312.3,156.15,,,,,,,,,,,,
Tx Sup Wnd Dehis Smp Cls 12020,4612333,CDM,12020,CPT,Facility,outpatient,,,,1070,535,,,,,,,,,,,,
Exc Arm/elbow Les SC<3cm 24075,4612676,CDM,24075,CPT,Facility,inpatient,,,,2108.4,1054.2,,,,,,,,,,,,
ClTx Nose Fx w/o Stablz 21315,4614444,CDM,21315,CPT,Facility,inpatient,,,,957,478.5,,,,,,,,,,,,
Exc Neck/thrx SC>= 3 cm 21552,4614447,CDM,21552,CPT,Facility,inpatient,,,,1321,660.5,,,,,,,,,,,,
Tracheobrnchscp EstTrach 31615,4614466,CDM,31615,CPT,Facility,both,,,,677.4,338.7,,,,,,,,,,,,
Fern test Q0114,4619838,CDM,Q0114,HCPCS,Facility,both,,,,38.96,19.48,,,,,,,,,,,,
Deb Bone Ea Addl 20sqcm  11047,4625750,CDM,11047,CPT,Facility,both,,,,1275,637.5,,,,,,,,,,,,
Us Preg <14Wk Abd Ea Add 76802,4631220,CDM,76802,CPT,Facility,both,,,,721,360.5,,,,,,,,,,,,
Fetal Echocardiography 76825,4631222,CDM,76825,CPT,Facility,both,,,,1800,900,,,,,,,,,,,,
Transvag Us Obst w/oth 76817,4648884,CDM,76817,CPT,Facility,both,,,,379,189.5,,,,,,,,,,,,
Apply Long Leg Splint 29505,4661420,CDM,29505,CPT,Facility,both,,,,99,49.5,,,,,,,,,,,,
EKG TRACING ONLY,5001001,CDM,93005,CPT,Facility,outpatient,,,,384.25,192.13,,,,,,,,,,,,
HM RECORDING,5001002,CDM,93225,CPT,Facility,outpatient,,,,575.8,287.9,,,,,,,,,,,,
HOLTER MONITOR SCAN,5001003,CDM,93226,CPT,Facility,outpatient,,,,575.8,287.9,,,,,,,,,,,,
EKG (REPEAT),5001004,CDM,93005,CPT,Facility,both,,,,284.25,142.13,,,,,,,,,,,,
Exc Bgn Lesn w/Margins 11426,5018190,CDM,11426,CPT,Facility,both,,,,3801,1900.5,,,,,,,,,,,,
Exc Bgn Lesn w/Margins 11444,5018192,CDM,11444,CPT,Facility,both,,,,1153,576.5,,,,,,,,,,,,
Exc Bgn Lesn w/Margins 11446,5018193,CDM,11446,CPT,Facility,both,,,,2803,1401.5,,,,,,,,,,,,
Rem FB Ext Audt Cnl w/An 69205,5205828,CDM,69205,CPT,Facility,both,,,,369.16,184.58,,,,,,,,,,,,
Dbd&RmvFMFx/dxSiteSk/SC/m11011,5206073,CDM,11011,CPT,Facility,both,,,,834,417,,,,,,,,,,,,
Exc Bgn Lesn w/Margins 11424,5206078,CDM,11424,CPT,Facility,both,,,,2204,1102,,,,,,,,,,,,
Exc Bgn Lesn w/Margins 11443,5206079,CDM,11443,CPT,Facility,both,,,,1153,576.5,,,,,,,,,,,,
Exc Pilonidl Cst/sinus S 11770,5206091,CDM,11770,CPT,Facility,both,,,,70,35,,,,,,,,,,,,
CpxRp E/n/e/l 1.1-2.5cm 13153,5206101,CDM,13153,CPT,Facility,both,,,,797,398.5,,,,,,,,,,,,
Strapping Ankle/foot 29540,5206164,CDM,29540,CPT,Facility,both,,,,173,86.5,,,,,,,,,,,,
Superficial Muscl Biopsy 20200,5206171,CDM,20200,CPT,Facility,inpatient,,,,754,377,,,,,,,,,,,,
Drain Lesion Neck/chest 21501,5206191,CDM,21501,CPT,Facility,inpatient,,,,1722,861,,,,,,,,,,,,
Cld Tx Shldr Bld Fx wo m 23570,5206252,CDM,23570,CPT,Facility,inpatient,,,,951.92,475.96,,,,,,,,,,,,
Open Tx Scapula Fx 23585,5206253,CDM,23585,CPT,Facility,inpatient,,,,3833.12,1916.56,,,,,,,,,,,,
Cld Tx Prx Humers Fx w/m 23605,5206254,CDM,23605,CPT,Facility,inpatient,,,,1848.88,924.44,,,,,,,,,,,,
Cl Tx Shldr Dis w/m wo a 23650,5206257,CDM,23650,CPT,Facility,inpatient,,,,1166.16,583.08,,,,,,,,,,,,
ClTx Shoulder Dislocatn 23655,5206258,CDM,23655,CPT,Facility,inpatient,,,,1609.28,804.64,,,,,,,,,,,,
Drain Arm Bursa 23931,5206260,CDM,23931,CPT,Facility,inpatient,,,,624.68,312.34,,,,,,,,,,,,
Exc Olecranon Bursa 24105,5206266,CDM,24105,CPT,Facility,inpatient,,,,1407.28,703.64,,,,,,,,,,,,
Rem FB Upp Arm/elbow SC 24200,5206269,CDM,24200,CPT,Facility,inpatient,,,,1543,771.5,,,,,,,,,,,,
ClTx HumeralShftFx w/o M 24500,5206276,CDM,24500,CPT,Facility,inpatient,,,,1314.88,657.44,,,,,,,,,,,,
ClTx Humeral Shaft Fx w/M24505,5206277,CDM,24505,CPT,Facility,inpatient,,,,1982,991,,,,,,,,,,,,
ClTx Humrl Sprcndlr w/m 24535,5206280,CDM,24535,CPT,Facility,inpatient,,,,2430.92,1215.46,,,,,,,,,,,,
ClTx Humeral Epcndlr w/m 24565,5206285,CDM,24565,CPT,Facility,inpatient,,,,2127.24,1063.62,,,,,,,,,,,,
Treat Elbow Disl w/an  24605,5206289,CDM,24605,CPT,Facility,inpatient,,,,2359,1179.5,,,,,,,,,,,,
Treat Elbow Fracture  24635,5206291,CDM,24635,CPT,Facility,inpatient,,,,4087,2043.5,,,,,,,,,,,,
ClTx Ulnar Fx PrxEnd W/oM24670,5206295,CDM,24670,CPT,Facility,inpatient,,,,1055.32,527.66,,,,,,,,,,,,
CldTx Ulnr Shft Fx w/o m 25530,5206315,CDM,25530,CPT,Facility,both,,,,951.16,475.58,,,,,,,,,,,,
Drain Finger Abscess Smp 26010,5206330,CDM,26010,CPT,Facility,both,,,,875,437.5,,,,,,,,,,,,
Drain Finger Abscess Cmp 26011,5206331,CDM,26011,CPT,Facility,both,,,,1471,735.5,,,,,,,,,,,,
Drn TendonShth Digt/Palm 26020,5206332,CDM,26020,CPT,Facility,both,,,,2063,1031.5,,,,,,,,,,,,
Cl Tx Distl Phlnx Fx w/m 26755,5206371,CDM,26755,CPT,Facility,both,,,,1084.88,542.44,,,,,,,,,,,,
Treat Finger Dislocation 26775,5206375,CDM,26775,CPT,Facility,both,,,,1546.24,773.12,,,,,,,,,,,,
Drain Thigh/knee Lesion 27301,5206408,CDM,27301,CPT,Facility,inpatient,,,,2639.56,1319.78,,,,,,,,,,,,
Drain Lower Leg Lesion 27603,5206453,CDM,27603,CPT,Facility,inpatient,,,,2084.36,1042.18,,,,,,,,,,,,
Exc Leg/ankl Tmr SC< 3cm 27618,5206457,CDM,27618,CPT,Facility,inpatient,,,,1547,773.5,,,,,,,,,,,,
ClTx Post Ankle Fx w/o M 27767,5206475,CDM,27767,CPT,Facility,inpatient,,,,927,463.5,,,,,,,,,,,,
Remove FB Foot SC 28190,5206494,CDM,28190,CPT,Facility,both,,,,516.72,258.36,,,,,,,,,,,,
Remove FB Foot 28192,5206495,CDM,28192,CPT,Facility,both,,,,1789.32,894.66,,,,,,,,,,,,
Open Tx Great Toe Fx 28505,5206510,CDM,28505,CPT,Facility,both,,,,1969,984.5,,,,,,,,,,,,
Shoulder Arthroscopy Dx 29805,5206522,CDM,29805,CPT,Facility,both,,,,60,30,,,,,,,,,,,,
Shoulder Arthroscpy/Surg 29819,5206523,CDM,29819,CPT,Facility,both,,,,94,47,,,,,,,,,,,,
Arth Aided Tx Tibial Fx 29855,5206530,CDM,29855,CPT,Facility,both,,,,101,50.5,,,,,,,,,,,,
Tibial Arthroscopy/Surg  29856,5206531,CDM,29856,CPT,Facility,both,,,,101,50.5,,,,,,,,,,,,
Scop Knee OstchndrlAlgrft29867,5206533,CDM,29867,CPT,Facility,both,,,,140,70,,,,,,,,,,,,
"Knee Arthroscopy,Dx 29870",5206534,CDM,29870,CPT,Facility,both,,,,140,70,,,,,,,,,,,,
Neuroplasty CrplTnlMedNrv64721,5206540,CDM,64721,CPT,Facility,both,,,,1732.8,866.4,,,,,,,,,,,,
Revise Ulnar Nerve Elbow 64718,5206566,CDM,64718,CPT,Facility,both,,,,2344.88,1172.44,,,,,,,,,,,,
Admin Pneumococcl Vax Medicare,5230194,CDM,G0009,HCPCS,Facility,both,,,,81.74,40.87,,,,,,,,,,,,
AC Joint/bursa w/ US 20606,5246050,CDM,20606,CPT,Facility,both,,,,2192,1096,,,,,,,,,,,,
AC Joint/bursa w/ US 20611,5283843,CDM,20611,CPT,Facility,both,,,,2238,1119,,,,,,,,,,,,
US Extremity Non-Vasc Lm 76882,5291301,CDM,76882,CPT,Facility,both,,,,250,125,,,,,,,,,,,,
RT AIRWAY INHAL TRTMNTSB 94640,5397112,CDM,94640,CPT,Facility,both,,,,575,287.5,,,,,,,,,,,,
RT AIRWAY INHAL TRTMNTINT94640,5397113,CDM,94640,CPT,Facility,both,,,,575,287.5,,,,,,,,,,,,
RT Charge 6 Minute Walk,5488822,CDM,94618,CPT,Facility,both,,,,460.64,230.32,,,,,,,,,,,,
COPILOT SHEATH SIZE 3,5500001,CDM,,,Facility,both,,,,20,10,,,,,,,,,,,,
"INCE SPIR W/ HANDLE 5,000 ML",5500003,CDM,,,Facility,outpatient,,,,5,2.5,,,,,,,,,,,,
IMMOBILIZER KNEE SMALL,5500004,CDM,,,Facility,outpatient,,,,35,17.5,,,,,,,,,,,,
"APPLICATOR SILVER NITRATE 6""",5500005,CDM,,,Facility,both,,,,3,1.5,,,,,,,,,,,,
ADAP STER WATER 340 ML,5500006,CDM,,,Facility,both,,,,3,1.5,,,,,,,,,,,,
PICC/CVC DRESSING CHANGE KIT,5500007,CDM,,,Facility,both,,,,63,31.5,,,,,,,,,,,,
BLOOD SAMPLING KIT (ABG),5500008,CDM,,,Facility,outpatient,,,,9,4.5,,,,,,,,,,,,
PUREWICK,5500009,CDM,,,Facility,both,,,,95,47.5,,,,,,,,,,,,
ANTI-STATIC MDI SPACER,5500010,CDM,,,Facility,outpatient,,,,11,5.5,,,,,,,,,,,,
TB 1 ML SYRINGE NEEDLE,5500016,CDM,,,Facility,both,,,,10,5,,,,,,,,,,,,
5-0 VICRYL SUTURE J283G,5500017,CDM,,,Facility,both,,,,120,60,,,,,,,,,,,,
"GASTRIC ACCESS LA TUBE, SIZE 2",5500018,CDM,,,Facility,both,,,,113,56.5,,,,,,,,,,,,
TRACHE BOUGIE W/ CO 70 CM,5500020,CDM,,,Facility,both,,,,21,10.5,,,,,,,,,,,,
FIBER LED LARYN BLADE #0,5500021,CDM,,,Facility,both,,,,14,7,,,,,,,,,,,,
FIBER ED LARY BLADE #2,5500022,CDM,,,Facility,both,,,,14,7,,,,,,,,,,,,
FIBER LED LARYN  HAN 3CM MED,5500023,CDM,,,Facility,both,,,,21,10.5,,,,,,,,,,,,
MIDLINE KIT W/ PLACEMENT WIRE,5500024,CDM,,,Facility,both,,,,130,65,,,,,,,,,,,,
"LARY UNIQUE PLUS MASK, INFANT",5500026,CDM,A4657,HCPCS,Facility,both,,,,58,29,,,,,,,,,,,,
FIBER LED LARYE BLADE #1,5500028,CDM,,,Facility,both,,,,14,7,,,,,,,,,,,,
COPILOT SHEATH SIZE 4,5500029,CDM,,,Facility,both,,,,20,10,,,,,,,,,,,,
FIBER OPTIC LED LARYN BLADE #3,5500030,CDM,,,Facility,both,,,,14,7,,,,,,,,,,,,
SPLINT FINGER 2.5 X 3,5500033,CDM,29130,CPT,Facility,Inpatient,,,,11,5.5,,,,,,,,,,,,
TRAY IRRIGATION,5500046,CDM,,,Facility,both,,,,12,6,,,,,,,,,,,,
SPLINT WRIST & FORE ABD  LT LG,5500070,CDM,,,Facility,both,,,,25,12.5,,,,,,,,,,,,
SPLINT WRIST & FOREARM LT LG,5500074,CDM,,,Facility,both,,,,25,12.5,,,,,,,,,,,,
HUM PREFI W/650 ML STE WATER,5500075,CDM,,,Facility,both,,,,3,1.5,,,,,,,,,,,,
HUM PREFI W/340 ML STE WATER,5500083,CDM,,,Facility,both,,,,3,1.5,,,,,,,,,,,,
STERI STRIP 1/4 X 3,5500089,CDM,,,Facility,both,,,,5,2.5,,,,,,,,,,,,
STERI STRIP 1/4 X 4,5500090,CDM,,,Facility,both,,,,10,5,,,,,,,,,,,,
CATHETER KIT (MALE),5500091,CDM,,,Facility,both,,,,20,10,,,,,,,,,,,,
TRAY SUTURE SET (LAC TRAY),5500103,CDM,,,Facility,both,,,,50,25,,,,,,,,,,,,
TEGADERM  2.375 X 2.75,5500106,CDM,,,Facility,both,,,,3,1.5,,,,,,,,,,,,
DRE TELFA OUCHLESS 2X3,5500108,CDM,,,Facility,both,,,,1,0.5,,,,,,,,,,,,
DRES TELFA OUCHLESS 3X8,5500109,CDM,,,Facility,both,,,,2,1,,,,,,,,,,,,
OXYGEN; DAILY,5500114,CDM,,,Facility,both,,,,19,9.5,,,,,,,,,,,,
HEMOSTATIC CLIPPING DEVICE,5500118,CDM,,,Facility,both,,,,775,387.5,,,,,,,,,,,,
ABDOMINAL BINDER,5501002,CDM,,,Facility,both,,,,42,21,,,,,,,,,,,,
ADHSV SKN DERMABOND,5501003,CDM,,,Facility,both,,,,115,57.5,,,,,,,,,,,,
AIRWAY NASAL 24FR,5501004,CDM,,,Facility,both,,,,22,11,,,,,,,,,,,,
AIRWAY INTUBATOR 7.5,5501006,CDM,,,Facility,both,,,,25,12.5,,,,,,,,,,,,
AIRWAY INTUBATOR 8.5,5501007,CDM,,,Facility,both,,,,25,12.5,,,,,,,,,,,,
AIRWAY NASAL 28FR,5501008,CDM,,,Facility,both,,,,25,12.5,,,,,,,,,,,,
AIRWAY NASAL 32FR,5501009,CDM,,,Facility,both,,,,35,17.5,,,,,,,,,,,,
AIRWAY NASAL 7.5MM,5501010,CDM,,,Facility,both,,,,25,12.5,,,,,,,,,,,,
AIRWAY SIZE 1,5501011,CDM,,,Facility,both,,,,22,11,,,,,,,,,,,,
AIRWAY SIZE 2,5501012,CDM,,,Facility,both,,,,22,11,,,,,,,,,,,,
AIRWAY SIZE 3,5501013,CDM,,,Facility,both,,,,5,2.5,,,,,,,,,,,,
AIRWAY SIZE 4,5501014,CDM,,,Facility,both,,,,5,2.5,,,,,,,,,,,,
AQUACEL DRES AG 4X4,5501015,CDM,,,Facility,both,,,,52,26,,,,,,,,,,,,
BAG LEG WITH ADAPTOR,5501016,CDM,,,Facility,both,,,,15,7.5,,,,,,,,,,,,
BREATHING CIRCUIT,5501022,CDM,,,Facility,both,,,,34,17,,,,,,,,,,,,
BREATHING CIRCUIT PE,5501023,CDM,,,Facility,both,,,,23,11.5,,,,,,,,,,,,
CANNULA NASAL INFANT,5501024,CDM,,,Facility,both,,,,12,6,,,,,,,,,,,,
CANNULA NASAL PEDIAT,5501025,CDM,,,Facility,both,,,,11,5.5,,,,,,,,,,,,
CANNULA/SUCTION 5MM,5501026,CDM,,,Facility,both,,,,120,60,,,,,,,,,,,,
CANNULA CO2 NASAL ADULT,5501027,CDM,,,Facility,both,,,,8,4,,,,,,,,,,,,
IV CATH CENTRAL VEIN 16,5501029,CDM,,,Facility,both,,,,74,37,,,,,,,,,,,,
CATH CONDOM L/F,5501030,CDM,,,Facility,both,,,,9,4.5,,,,,,,,,,,,
CATH FOGARTY 5FR,5501031,CDM,,,Facility,both,,,,256,128,,,,,,,,,,,,
CATH FOGARTY 6FR,5501032,CDM,,,Facility,both,,,,100,50,,,,,,,,,,,,
CATH FOLEY 10FR/W 3,5501033,CDM,,,Facility,both,,,,48,24,,,,,,,,,,,,
CATH FOLEY 18FR W,5501036,CDM,,,Facility,both,,,,30,15,,,,,,,,,,,,
CATH FOLEY 20FR,5501038,CDM,,,Facility,both,,,,30,15,,,,,,,,,,,,
CATH FOLEY 24 FR,5501039,CDM,,,Facility,both,,,,35,17.5,,,,,,,,,,,,
CATH FOLEY COUDE 14FR 5CC,5501040,CDM,,,Facility,both,,,,48,24,,,,,,,,,,,,
CATH FOLEY COUDE 16F,5501041,CDM,,,Facility,both,,,,48,24,,,,,,,,,,,,
CATH FOLEY COUDE 18F,5501042,CDM,,,Facility,both,,,,48,24,,,,,,,,,,,,
TRAY FOLEY CATH 18FR L/F,5501044,CDM,,,Facility,both,,,,30,15,,,,,,,,,,,,
CATH KIT FEMALE GLOV,5501045,CDM,,,Facility,both,,,,35,17.5,,,,,,,,,,,,
CATH SECURE DUAL TAB,5501047,CDM,,,Facility,both,,,,13,6.5,,,,,,,,,,,,
CATH SUCTION 10 FR,5501048,CDM,,,Facility,both,,,,5,2.5,,,,,,,,,,,,
CATH SUCTION 14FR,5501049,CDM,,,Facility,both,,,,1,0.5,,,,,,,,,,,,
CATH SUCTION 8FR PED,5501050,CDM,,,Facility,both,,,,6,3,,,,,,,,,,,,
CATH URETHRAL 16FR,5501052,CDM,,,Facility,both,,,,3,1.5,,,,,,,,,,,,
CATH CONDOM 23MM,5501053,CDM,,,Facility,both,,,,9,4.5,,,,,,,,,,,,
CATH CONDOM 28MM,5501054,CDM,,,Facility,both,,,,9,4.5,,,,,,,,,,,,
URINE METER FOLY 16,5501055,CDM,,,Facility,both,,,,40,20,,,,,,,,,,,,
CATHETER PLUG,5501056,CDM,,,Facility,both,,,,1,0.5,,,,,,,,,,,,
CATHETER TACH 14FR,5501057,CDM,,,Facility,both,,,,43,21.5,,,,,,,,,,,,
CHEST DRAIN HEIMLICH,5501059,CDM,,,Facility,both,,,,71,35.5,,,,,,,,,,,,
COHESIVE PAD ENDO,5501064,CDM,,,Facility,both,,,,16,8,,,,,,,,,,,,
C-COLLAR PED,5501065,CDM,,,Facility,both,,,,63,31.5,,,,,,,,,,,,
OPTIFLOW KIT W/ MICROCELL,5501066,CDM,,,Facility,both,,,,164,82,,,,,,,,,,,,
C-COLLAR LARGE,5501068,CDM,,,Facility,both,,,,35,17.5,,,,,,,,,,,,
BAG COLOSTOMY,5501076,CDM,,,Facility,both,,,,52,26,,,,,,,,,,,,
COLOSTOMY ILLEOSTOMY,5501077,CDM,,,Facility,both,,,,54,27,,,,,,,,,,,,
COLOSTOMY WAFER,5501078,CDM,,,Facility,both,,,,57,28.5,,,,,,,,,,,,
MASK CPAP/BIPAP FULL MED,5501079,CDM,,,Facility,both,,,,167,83.5,,,,,,,,,,,,
CRICOTHYROTOMY 6MM,5501080,CDM,,,Facility,both,,,,648,324,,,,,,,,,,,,
CANOPY CROUP TENT,5501081,CDM,,,Facility,both,,,,60,30,,,,,,,,,,,,
CRUTCH ADULT,5501083,CDM,,,Facility,both,,,,43,21.5,,,,,,,,,,,,
CRUTCH YOUTH,5501086,CDM,,,Facility,both,,,,61,30.5,,,,,,,,,,,,
CUSHION RING POSTERIOR,5501087,CDM,,,Facility,both,,,,58,29,,,,,,,,,,,,
DETECTOR CO2 ADULT,5501090,CDM,,,Facility,both,,,,61,30.5,,,,,,,,,,,,
CATH DILATION G15-18,5501092,CDM,,,Facility,both,,,,953,476.5,,,,,,,,,,,,
CATH DILATION GW8-10,5501094,CDM,,,Facility,both,,,,953,476.5,,,,,,,,,,,,
CATH DILATION GW10-12,5501095,CDM,,,Facility,both,,,,953,476.5,,,,,,,,,,,,
DILATOR COLON 12-15MM,5501096,CDM,,,Facility,both,,,,953,476.5,,,,,,,,,,,,
DRAIN PENROSE 1/4 X 18,5501097,CDM,,,Facility,both,,,,1,0.5,,,,,,,,,,,,
DRAIN ROUND TUBING J,5501098,CDM,,,Facility,both,,,,61,30.5,,,,,,,,,,,,
DRESS ADAPTIC 3X9,5501099,CDM,,,Facility,both,,,,6,3,,,,,,,,,,,,
ALGINATE DRESSING,5501100,CDM,,,Facility,both,,,,30,15,,,,,,,,,,,,
ADAP OXYNUT AND NIP UNIV,5501104,CDM,,,Facility,both,,,,3,1.5,,,,,,,,,,,,
ELECTRODES IONTOPHOR,5501105,CDM,,,Facility,both,,,,45,22.5,,,,,,,,,,,,
AIRWAY NASOPHARYNGEAL 30FR,5501107,CDM,,,Facility,both,,,,14,7,,,,,,,,,,,,
ELECTRODES PED LIFEP,5501108,CDM,,,Facility,both,,,,129,64.5,,,,,,,,,,,,
AIRWAY NASOPHARYNGEAL 34FR,5501109,CDM,,,Facility,both,,,,13,6.5,,,,,,,,,,,,
ENDO TUBE 2.5 MURPHY,5501111,CDM,,,Facility,both,,,,9,4.5,,,,,,,,,,,,
ENDO TUBE 3.0 MURPHY,5501112,CDM,,,Facility,both,,,,9,4.5,,,,,,,,,,,,
AIRWAY ET TUBE 3.5,5501113,CDM,,,Facility,both,,,,14,7,,,,,,,,,,,,
ENDO TUBE 4.0,5501114,CDM,,,Facility,both,,,,14,7,,,,,,,,,,,,
AIRWAY ET TUBE 4.5,5501115,CDM,,,Facility,both,,,,14,7,,,,,,,,,,,,
AIRWAY ET TUBE 5.0,5501116,CDM,,,Facility,both,,,,9,4.5,,,,,,,,,,,,
AIRWAY ET TUBE 5.5,5501117,CDM,,,Facility,both,,,,9,4.5,,,,,,,,,,,,
ENDO TUBE 6.0,5501118,CDM,,,Facility,both,,,,13,6.5,,,,,,,,,,,,
AIRWAY ET TUBE 6.5,5501120,CDM,,,Facility,both,,,,10,5,,,,,,,,,,,,
AIRWAY ET TUBE 7.0,5501121,CDM,,,Facility,both,,,,13,6.5,,,,,,,,,,,,
AIRWAY ET TUBE 7.5,5501122,CDM,,,Facility,both,,,,13,6.5,,,,,,,,,,,,
AIRWAY ET TUBE 8.0,5501123,CDM,,,Facility,both,,,,13,6.5,,,,,,,,,,,,
ENDO TUBE 8.5,5501124,CDM,,,Facility,both,,,,14,7,,,,,,,,,,,,
AIRWAY ET TUBE 9.0,5501125,CDM,,,Facility,both,,,,22,11,,,,,,,,,,,,
HOLDER TRACH TUBE,5501126,CDM,,,Facility,both,,,,8,4,,,,,,,,,,,,
HOLDER ET TUBE HOLDER OTHER,5501127,CDM,,,Facility,both,,,,27,13.5,,,,,,,,,,,,
TUBE FEEDING FLEXIB,5501130,CDM,,,Facility,both,,,,13,6.5,,,,,,,,,,,,
FLOWTRON CALF STOCK,5501131,CDM,,,Facility,both,,,,98,49,,,,,,,,,,,,
CANNULA INTERLINK 17G STE,5501132,CDM,,,Facility,both,,,,3,1.5,,,,,,,,,,,,
AIRWAY NASOPHARYNGEAL 26FR,5501134,CDM,,,Facility,both,,,,14,7,,,,,,,,,,,,
NEEDLE FILTER 19GX1.5,5501135,CDM,,,Facility,both,,,,3,1.5,,,,,,,,,,,,
TUBE SALEM SUMP 8FR W/ FUNNEL,5501136,CDM,,,Facility,both,,,,13,6.5,,,,,,,,,,,,
GRAVITY GAVAGE SET,5501139,CDM,,,Facility,both,,,,20,10,,,,,,,,,,,,
HIGH COMPRSS 4X3.5,5501145,CDM,,,Facility,both,,,,67,33.5,,,,,,,,,,,,
HND NEB MISTY W/TUBN,5501146,CDM,,,Facility,both,,,,13,6.5,,,,,,,,,,,,
HUMIDIFER O2 MED 300-500,5501147,CDM,,,Facility,both,,,,10,5,,,,,,,,,,,,
HUMIDIFIER O2 LG >501,5501148,CDM,,,Facility,both,,,,25,12.5,,,,,,,,,,,,
INFLAT SYS GAGE-SYRI,5501149,CDM,,,Facility,both,,,,475,237.5,,,,,,,,,,,,
INFUS WING 20X1 1/2,5501150,CDM,,,Facility,both,,,,221,110.5,,,,,,,,,,,,
KIDNEY STONE FILTER,5501152,CDM,,,Facility,both,,,,6,3,,,,,,,,,,,,
LAVACUATOR 28 FR,5501153,CDM,,,Facility,both,,,,324,162,,,,,,,,,,,,
LENS MEDI FLOW,5501154,CDM,,,Facility,both,,,,80,40,,,,,,,,,,,,
LMA/FASTRACH ET TUBE,5501160,CDM,,,Facility,both,,,,318,159,,,,,,,,,,,,
Y TYPE BLOOD SOL SET,5501162,CDM,,,Facility,both,,,,30,15,,,,,,,,,,,,
MASK FACE TENT,5501165,CDM,,,Facility,both,,,,6,3,,,,,,,,,,,,
MASK TRACH ADULT,5501166,CDM,,,Facility,both,,,,9,4.5,,,,,,,,,,,,
MASK VENTURI ADULT,5501167,CDM,,,Facility,both,,,,13,6.5,,,,,,,,,,,,
MASK AEROSOL ADULT,5501169,CDM,,,Facility,both,,,,39,19.5,,,,,,,,,,,,
MASK AEROSOL PED,5501170,CDM,,,Facility,both,,,,6,3,,,,,,,,,,,,
MASK BIPAP/CPAP NASAL SM,5501171,CDM,,,Facility,both,,,,116.81,58.41,,,,,,,,,,,,
MASK BIPAP/CPAP NASAL MED,5501172,CDM,,,Facility,both,,,,98,49,,,,,,,,,,,,
MASK CPAP W HEAD SM,5501173,CDM,,,Facility,both,,,,167,83.5,,,,,,,,,,,,
MASK NONREBREATHER ADULT,5501175,CDM,,,Facility,both,,,,9,4.5,,,,,,,,,,,,
MASK SPACER MED,5501176,CDM,,,Facility,both,,,,58,29,,,,,,,,,,,,
MASK SPACER SMALL,5501177,CDM,,,Facility,both,,,,58,29,,,,,,,,,,,,
MASK NONREBREATHER PED,5501178,CDM,,,Facility,both,,,,14,7,,,,,,,,,,,,
MASK VENTURI PED,5501179,CDM,,,Facility,both,,,,16,8,,,,,,,,,,,,
MAX-N-SENSOR,5501183,CDM,,,Facility,both,,,,77,38.5,,,,,,,,,,,,
METER PEAK FLOW,5501184,CDM,,,Facility,both,,,,50,25,,,,,,,,,,,,
SURGICAL GLOVES,5501186,CDM,,,Facility,both,,,,10,5,,,,,,,,,,,,
MUCUS TRAP STERILE,5501187,CDM,,,Facility,both,,,,9,4.5,,,,,,,,,,,,
ADAPTER NEBULIZER,5501188,CDM,,,Facility,both,,,,6,3,,,,,,,,,,,,
NEBULITZER EMPTY JET,5501189,CDM,,,Facility,both,,,,15,7.5,,,,,,,,,,,,
CIRCUIT TUBING CPAP/BIPAP 6',5501190,CDM,,,Facility,both,,,,30,15,,,,,,,,,,,,
NEEDL VERESS 120MM,5501194,CDM,,,Facility,both,,,,102,51,,,,,,,,,,,,
NOZ STOP UNIVERSAL B,5501195,CDM,,,Facility,both,,,,137,68.5,,,,,,,,,,,,
CONTIN FLOW MED SET 2 PORT,5501199,CDM,,,Facility,both,,,,32,16,,,,,,,,,,,,
PNEUMOTHORAX KIT,5501204,CDM,,,Facility,both,,,,109,54.5,,,,,,,,,,,,
PROBE INJ. CATH-GOLD,5501208,CDM,,,Facility,both,,,,970,485,,,,,,,,,,,,
TRAY PULL PEG,5501209,CDM,,,Facility,both,,,,644,322,,,,,,,,,,,,
PUMP SET KDS BAG,5501211,CDM,,,Facility,both,,,,16,8,,,,,,,,,,,,
RESUSCITATOR MANUAL,5501213,CDM,,,Facility,both,,,,45,22.5,,,,,,,,,,,,
AMBU BAG ADULT-BVM,5501214,CDM,,,Facility,both,,,,50,25,,,,,,,,,,,,
AMBU BAG PED-BVM,5501215,CDM,,,Facility,both,,,,50,25,,,,,,,,,,,,
SITZ BATH,5501230,CDM,,,Facility,both,,,,17,8.5,,,,,,,,,,,,
SNARE,5501234,CDM,,,Facility,both,,,,60,30,,,,,,,,,,,,
SPEC VAGINAL DISP MED,5501236,CDM,,,Facility,both,,,,12,6,,,,,,,,,,,,
SPECULA VAG DISP LG,5501237,CDM,,,Facility,both,,,,14,7,,,,,,,,,,,,
SPLINT AIR LT MED,5501244,CDM,,,Facility,both,,,,100,50,,,,,,,,,,,,
SPLINT AIR RT MED,5501245,CDM,,,Facility,both,,,,100,50,,,,,,,,,,,,
SPLINT AIR LT SM,5501246,CDM,,,Facility,both,,,,100,50,,,,,,,,,,,,
SPLINT AIR RT SM,5501247,CDM,,,Facility,both,,,,100,50,,,,,,,,,,,,
SPLINT AIR STANDARD,5501248,CDM,,,Facility,both,,,,100,50,,,,,,,,,,,,
SPLINT BASEBALL SMALL,5501250,CDM,,,Facility,both,,,,9,4.5,,,,,,,,,,,,
SPLINT COLLES CHILD,5501251,CDM,,,Facility,both,,,,44,22,,,,,,,,,,,,
SPLINT COLLES SMALL,5501252,CDM,,,Facility,both,,,,41,20.5,,,,,,,,,,,,
SPLINT FINGER-3 X 3.5,5501254,CDM,,,Facility,both,,,,11,5.5,,,,,,,,,,,,
SPLINT FINGER-6,5501255,CDM,,,Facility,both,,,,16,8,,,,,,,,,,,,
SPLINT SPEED HAND-AD,5501256,CDM,,,Facility,both,,,,56,28,,,,,,,,,,,,
SPLINT TIB FIB/CHILD,5501257,CDM,,,Facility,both,,,,105,52.5,,,,,,,,,,,,
SPLINT TIBIA FIBULA,5501258,CDM,,,Facility,both,,,,202,101,,,,,,,,,,,,
STOCK ANTI EMBO THIG,5501262,CDM,,,Facility,both,,,,38,19,,,,,,,,,,,,
STOCK ANTI EMB THI SHT XL,5501263,CDM,,,Facility,both,,,,35,17.5,,,,,,,,,,,,
STOCK ANTI EMB KNEE HI REG XL,5501264,CDM,,,Facility,both,,,,73,36.5,,,,,,,,,,,,
STOCK ANTIEM THIGH L,5501265,CDM,,,Facility,both,,,,73,36.5,,,,,,,,,,,,
STOCK ANTIEM THIGH L,5501266,CDM,,,Facility,both,,,,36,18,,,,,,,,,,,,
STOCK ANTIEM THIGH S,5501267,CDM,,,Facility,both,,,,38,19,,,,,,,,,,,,
STOCKING ANTIEM KNE,5501269,CDM,,,Facility,both,,,,47,23.5,,,,,,,,,,,,
STOCKING ANTIEMBOL L,5501270,CDM,,,Facility,both,,,,24,12,,,,,,,,,,,,
STOPCOCK 3 WAY,5501271,CDM,,,Facility,both,,,,6,3,,,,,,,,,,,,
STRAPS HEAD AND CHIN,5501272,CDM,,,Facility,both,,,,133,66.5,,,,,,,,,,,,
SUCTION TIP POOLE,5501274,CDM,,,Facility,both,,,,18,9,,,,,,,,,,,,
SUCTION YANKAUER,5501276,CDM,,,Facility,both,,,,3,1.5,,,,,,,,,,,,
AIRWAY TRACH TUBE 6.0,5501284,CDM,,,Facility,both,,,,123,61.5,,,,,,,,,,,,
TRACHEOSTOMY TUBE 3.,5501286,CDM,,,Facility,both,,,,135,67.5,,,,,,,,,,,,
TRACHEOSTOMY TUBE 4.,5501287,CDM,,,Facility,both,,,,140,70,,,,,,,,,,,,
TRACHEOSTOMY TUBE 5.,5501288,CDM,,,Facility,both,,,,123,61.5,,,,,,,,,,,,
TRACHEOSTOMY TUBE 7.,5501289,CDM,,,Facility,both,,,,123,61.5,,,,,,,,,,,,
TRACHEOSTOMY TUBE 8.,5501290,CDM,,,Facility,both,,,,123,61.5,,,,,,,,,,,,
TRACHESTOMY TUBE 9.0,5501291,CDM,,,Facility,both,,,,128,64,,,,,,,,,,,,
TRANSVERSE LAP SHEET,5501292,CDM,,,Facility,both,,,,43,21.5,,,,,,,,,,,,
TRAY IRRIGATION,5501293,CDM,,,Facility,both,,,,12,6,,,,,,,,,,,,
TRAY PARACENTESIS,5501294,CDM,,,Facility,both,,,,129,64.5,,,,,,,,,,,,
TRAY THORAC/PARACE,5501296,CDM,,,Facility,both,,,,89,44.5,,,,,,,,,,,,
TROCAR REDUCER CAPS,5501297,CDM,,,Facility,both,,,,41,20.5,,,,,,,,,,,,
TROCAR THORACIC 24 -,5501298,CDM,,,Facility,both,,,,79,39.5,,,,,,,,,,,,
TUBE FEEDING 12FR,5501300,CDM,,,Facility,both,,,,42,21,,,,,,,,,,,,
TUBE LEVIN 10FR,5501302,CDM,,,Facility,both,,,,19,9.5,,,,,,,,,,,,
TUBE LEVIN 18FR,5501303,CDM,,,Facility,both,,,,16,8,,,,,,,,,,,,
TUBE RECTAL,5501304,CDM,,,Facility,both,,,,16,8,,,,,,,,,,,,
TUBE FEEDING 14FR,5501305,CDM,,,Facility,both,,,,16,8,,,,,,,,,,,,
TUBE SALEM SUMP 16FR,5501306,CDM,,,Facility,both,,,,60,30,,,,,,,,,,,,
TUBE STOMACH 12FR,5501307,CDM,,,Facility,both,,,,6,3,,,,,,,,,,,,
CATH URETHRAL 5FR,5501312,CDM,,,Facility,both,,,,34,17,,,,,,,,,,,,
URINARY DRAINAGE BAG,5501313,CDM,,,Facility,both,,,,23,11.5,,,,,,,,,,,,
TRAY URINE METER 18FR,5501315,CDM,,,Facility,both,,,,60,30,,,,,,,,,,,,
VALVE PEEP,5501317,CDM,,,Facility,both,,,,41,20.5,,,,,,,,,,,,
VENT HUMID,5501319,CDM,,,Facility,both,,,,13,6.5,,,,,,,,,,,,
STERILE WATER 500ML,5501321,CDM,,,Facility,both,,,,15,7.5,,,,,,,,,,,,
7-0 SILK OPHTH,5501326,CDM,,,Facility,both,,,,115,57.5,,,,,,,,,,,,
ABD PAD,5501328,CDM,,,Facility,both,,,,1.75,0.88,,,,,,,,,,,,
AEROCHAMBER,5501329,CDM,,,Facility,both,,,,62,31,,,,,,,,,,,,
BANDAGE ELASTIC 2 INCH,5501351,CDM,,,Facility,both,,,,5,2.5,,,,,,,,,,,,
"BANDAGE ELASTIC 3""",5501352,CDM,,,Facility,both,,,,5,2.5,,,,,,,,,,,,
BANDAGE ELASTIC 4 INCH,5501353,CDM,,,Facility,both,,,,5,2.5,,,,,,,,,,,,
BANDAGE ELASTIC 6 INCH,5501354,CDM,,,Facility,both,,,,10,5,,,,,,,,,,,,
BANDAGE ELASTIC CO-BAN,5501355,CDM,,,Facility,both,,,,5,2.5,,,,,,,,,,,,
CATHETER HOLDER,5501386,CDM,,,Facility,both,,,,31,15.5,,,,,,,,,,,,
CHEST DRAIN PLEUR-EVAC,5501401,CDM,,,Facility,both,,,,322,161,,,,,,,,,,,,
ENEMA CLEANING SET,5501438,CDM,,,Facility,both,,,,15,7.5,,,,,,,,,,,,
EXTENSION SET,5501456,CDM,,,Facility,both,,,,9,4.5,,,,,,,,,,,,
FILTER 1.2 IV TUBING,5501461,CDM,,,Facility,both,,,,23,11.5,,,,,,,,,,,,
DRESS VASELINE ST/,5501471,CDM,,,Facility,both,,,,152,76,,,,,,,,,,,,
HEEL & ELBOW PROTECTOR,5501475,CDM,,,Facility,both,,,,49,24.5,,,,,,,,,,,,
"BANDAGE GAUZE ROLL 4""",5501538,CDM,,,Facility,both,,,,3,1.5,,,,,,,,,,,,
IMMOBILIZER KNEE LG,5501543,CDM,,,Facility,both,,,,36,18,,,,,,,,,,,,
OP SITE WOUND SIZE,5501572,CDM,,,Facility,both,,,,132,66,,,,,,,,,,,,
J LOOP TUBE CONNECTOR,5501574,CDM,,,Facility,both,,,,32,16,,,,,,,,,,,,
PORT-A-CATH GRIPPER,5501586,CDM,,,Facility,both,,,,47,23.5,,,,,,,,,,,,
PREP IOD GEN,5501587,CDM,,,Facility,both,,,,6,3,,,,,,,,,,,,
SPLINT FINGER BASEBALL,5501620,CDM,,,Facility,both,,,,7,3.5,,,,,,,,,,,,
"SPLINT, FINGER 2.25 X 2.75",5501627,CDM,,,Facility,both,,,,10,5,,,,,,,,,,,,
SPONGE DRAIN,5501628,CDM,,,Facility,both,,,,19,9.5,,,,,,,,,,,,
SPONGES ST 4 X 4 (2PKG),5501638,CDM,,,Facility,both,,,,3,1.5,,,,,,,,,,,,
STAPLE REMOVAL KIT,5501639,CDM,,,Facility,both,,,,6,3,,,,,,,,,,,,
SUTURE ETHIB CNTL REL 2-0,5501658,CDM,,,Facility,both,,,,125,62.5,,,,,,,,,,,,
SYRINGE IRRIGATING BULB,5501677,CDM,,,Facility,both,,,,3,1.5,,,,,,,,,,,,
SUTURE REMOVAL KIT,5501715,CDM,,,Facility,both,,,,21,10.5,,,,,,,,,,,,
"KLING 3""",5501741,CDM,,,Facility,both,,,,20,10,,,,,,,,,,,,
DRES SPONGES 4 X 4 TRAY,5501873,CDM,,,Facility,both,,,,10,5,,,,,,,,,,,,
"IMMOBILIZER KNEE 19"" MEDIUM",5501893,CDM,,,Facility,both,,,,36,18,,,,,,,,,,,,
OXISENSOR PEDI,5501951,CDM,,,Facility,both,,,,78,39,,,,,,,,,,,,
OXISENSOR ADULT,5501952,CDM,,,Facility,both,,,,77,38.5,,,,,,,,,,,,
DRESS TELFA PAD 3 X 4,5502099,CDM,,,Facility,both,,,,1.5,0.75,,,,,,,,,,,,
DRESG VASELINE  3X9,5502122,CDM,,,Facility,both,,,,10,5,,,,,,,,,,,,
SPLINT WRIST/ARM UNIVERSAL,5502130,CDM,,,Facility,both,,,,10,5,,,,,,,,,,,,
SPLINT WRIST&FOREARM MD LFT,5502133,CDM,,,Facility,both,,,,25,12.5,,,,,,,,,,,,
SPLINT WRIST&FOREARM MD RT,5502134,CDM,,,Facility,both,,,,25,12.5,,,,,,,,,,,,
YANKAUER TIP W/TUBING,5502142,CDM,,,Facility,both,,,,10,5,,,,,,,,,,,,
NITRO TUBING,5502267,CDM,,,Facility,both,,,,33,16.5,,,,,,,,,,,,
OXISENSOR NEONATE,5502274,CDM,,,Facility,both,,,,69,34.5,,,,,,,,,,,,
"PACKING-IODOFORM 1""",5502285,CDM,,,Facility,both,,,,26,13,,,,,,,,,,,,
"PACKING-IODOFORM 1/2""",5502286,CDM,,,Facility,both,,,,25,12.5,,,,,,,,,,,,
SPECULA VAG DISP SMALL,5502323,CDM,,,Facility,both,,,,5,2.5,,,,,,,,,,,,
VAC CANNISTER W/ GEL,5502347,CDM,,,Facility,both,,,,115,57.5,,,,,,,,,,,,
WOUND VAC LG DRESSING,5502355,CDM,,,Facility,both,,,,246,123,,,,,,,,,,,,
WOUND VAC-SM WHT FOAM,5502356,CDM,,,Facility,both,,,,39,19.5,,,,,,,,,,,,
MODERATE SEDATION INITIAL 15 MIN,5502534,CDM,,,Facility,both,,,,165,82.5,,,,,,,,,,,,
MODERATE SEDATION ADD 15 MIN,5502535,CDM,,,Facility,both,,,,62,31,,,,,,,,,,,,
VAC CANISTER,5502593,CDM,,,Facility,both,,,,77,38.5,,,,,,,,,,,,
VAC MED. BLACK FOAM DRESSING,5502595,CDM,,,Facility,both,,,,210,105,,,,,,,,,,,,
IV VIAL ADAPTER,5502599,CDM,,,Facility,both,,,,10,5,,,,,,,,,,,,
EXTESET W/CONTROL-A-FLO REG,5502602,CDM,,,Facility,both,,,,3,1.5,,,,,,,,,,,,
WOUND VAC PUMP,5502709,CDM,,,Facility,both,,,,94,47,,,,,,,,,,,,
AIR MATTRESS BED,5502710,CDM,,,Facility,both,,,,1220,610,,,,,,,,,,,,
CO2 DETECTOR,5502714,CDM,,,Facility,both,,,,48,24,,,,,,,,,,,,
INCENTIVE SPIROMETER,5502792,CDM,,,Facility,both,,,,53,26.5,,,,,,,,,,,,
SUCTION CATH 10 FR,5502890,CDM,,,Facility,both,,,,40,20,,,,,,,,,,,,
CANNULA ADULT 7' TUBE,5502934,CDM,,,Facility,both,,,,3,1.5,,,,,,,,,,,,
"SYRINGE, LUER LOCK 20 ML",5502935,CDM,,,Facility,both,,,,3,1.5,,,,,,,,,,,,
WIPES SUREPREP SKIN PROTECTANT,5502939,CDM,,,Facility,both,,,,3,1.5,,,,,,,,,,,,
CATH URETHRAL 14-16 FR,5502963,CDM,,,Facility,both,,,,5,2.5,,,,,,,,,,,,
SECONDARY SET,5503080,CDM,,,Facility,both,,,,14,7,,,,,,,,,,,,
HEEL PROTECTOR QUILTED,5503095,CDM,,,Facility,both,,,,67,33.5,,,,,,,,,,,,
TROCAR 12MM X 100MM,5503131,CDM,,,Facility,both,,,,777,388.5,,,,,,,,,,,,
ENDO TUBE 2.0 MURPHY,5503132,CDM,,,Facility,both,,,,9,4.5,,,,,,,,,,,,
AIRWAY LMA UNIQUE SIZE 1 PP,5503133,CDM,,,Facility,both,,,,58,29,,,,,,,,,,,,
AIRWAY LMA UNIQUE SIZE 1.5 PP,5503137,CDM,,,Facility,both,,,,58,29,,,,,,,,,,,,
NEEDLE HUBER 20 GA 1 IN,5503185,CDM,,,Facility,both,,,,8,4,,,,,,,,,,,,
CUFF CHILD DISP,5503236,CDM,,,Facility,both,,,,38,19,,,,,,,,,,,,
ADULT CUFF DISP,5503244,CDM,,,Facility,both,,,,43,21.5,,,,,,,,,,,,
ADULT CUFF LARGE DISP,5503245,CDM,,,Facility,both,,,,50,25,,,,,,,,,,,,
ADULT DISP O2 SENSOR,5503246,CDM,,,Facility,both,,,,69,34.5,,,,,,,,,,,,
ESOPHSTETHOSCOPE 18F,5505001,CDM,,,Facility,both,,,,20,10,,,,,,,,,,,,
KING AIRWAY # 4,5510072,CDM,,,Facility,both,,,,173,86.5,,,,,,,,,,,,
KING AIRWAY # 5,5510073,CDM,,,Facility,both,,,,173,86.5,,,,,,,,,,,,
ENDOTRACH TUBE 6.0MM,5510086,CDM,,,Facility,both,,,,229,114.5,,,,,,,,,,,,
STYLET INTUBATING DISP 14FR,5510226,CDM,,,Facility,both,,,,211,105.5,,,,,,,,,,,,
SUCTION TUBING 10',5510227,CDM,,,Facility,both,,,,17,8.5,,,,,,,,,,,,
INJECTION SITE,5510328,CDM,,,Facility,both,,,,14,7,,,,,,,,,,,,
CHLORA PREP 10.5 ML,5510368,CDM,,,Facility,both,,,,30,15,,,,,,,,,,,,
CHLORA PREP 26 ML,5510369,CDM,,,Facility,both,,,,44,22,,,,,,,,,,,,
WOUND VAC DRESSING BRIDGE,5510370,CDM,,,Facility,both,,,,70,35,,,,,,,,,,,,
STOCK PO KNEE HIGH SM,5510568,CDM,,,Facility,both,,,,23,11.5,,,,,,,,,,,,
SLING & SWATHE UNIVERSAL,5510571,CDM,,,Facility,both,,,,35,17.5,,,,,,,,,,,,
SPLINT BASEBALL LG,5510573,CDM,,,Facility,both,,,,45,22.5,,,,,,,,,,,,
DRESS ADAPTIC 3X3,5510597,CDM,,,Facility,both,,,,3,1.5,,,,,,,,,,,,
IMMOBILIZER KNEE 24 XLG,5510605,CDM,,,Facility,both,,,,52,26,,,,,,,,,,,,
SPONGE 2X2 STER,5510661,CDM,,,Facility,both,,,,3,1.5,,,,,,,,,,,,
BIOPSY FORCEP 2 3X230 LOWER,5510706,CDM,,,Facility,both,,,,24,12,,,,,,,,,,,,
DRESS MEPILEX 4X4,5511533,CDM,,,Facility,both,,,,40,20,,,,,,,,,,,,
IV CATH INTROCAN 24GA,5511534,CDM,,,Facility,both,,,,9,4.5,,,,,,,,,,,,
IV CATH INTROCAN 22GA,5511535,CDM,,,Facility,both,,,,9,4.5,,,,,,,,,,,,
IV CATH INTROCAN 20GA,5511536,CDM,,,Facility,both,,,,9,4.5,,,,,,,,,,,,
IV CATH INTROCAN 18GA,5511537,CDM,,,Facility,both,,,,9,4.5,,,,,,,,,,,,
MARKER SPOT ENDOSCOPIC,5511568,CDM,,,Facility,both,,,,138,69,,,,,,,,,,,,
TENS ELECTRODE 2 X 3.5,5511583,CDM,,,Facility,both,,,,50,25,,,,,,,,,,,,
WOUND VAC SMALL DRESS,5511663,CDM,,,Facility,both,,,,35.08,17.54,,,,,,,,,,,,
SUTURE 4-0 VICRYL J845,5511721,CDM,,,Facility,both,,,,46,23,,,,,,,,,,,,
DRE MEDIPORE 3 1/2 X 8,5511727,CDM,,,Facility,both,,,,5,2.5,,,,,,,,,,,,
GASTROSTOMY TUBE 20FR,5511728,CDM,,,Facility,both,,,,187,93.5,,,,,,,,,,,,
INTRAOSSEOUS 15MM,5511791,CDM,,,Facility,both,,,,139,69.5,,,,,,,,,,,,
DRESS OPTIFOAM 8X8,5511801,CDM,,,Facility,both,,,,42,21,,,,,,,,,,,,
IV CATH INTROCAN 16 G,5511802,CDM,,,Facility,both,,,,9,4.5,,,,,,,,,,,,
MASK AEROSOL SMALL W/ ELBOW,5511805,CDM,,,Facility,both,,,,200.7,100.35,,,,,,,,,,,,
MASK AEROSOL MEDIUM W/ ELBOW,5511806,CDM,,,Facility,both,,,,200.7,100.35,,,,,,,,,,,,
Body Bags,5520000,CDM,,,Facility,both,,,,54,27,,,,,,,,,,,,
Border gauze dressing 4 x 4,5520002,CDM,,,Facility,both,,,,4,2,,,,,,,,,,,,
Border gauze dressing 6 x 6,5520003,CDM,,,Facility,both,,,,5,2.5,,,,,,,,,,,,
NG Strips,5520004,CDM,,,Facility,both,,,,4,2,,,,,,,,,,,,
Flexi-Seal Bags,5520005,CDM,,,Facility,both,,,,37,18.5,,,,,,,,,,,,
Flexi-Seal Collector,5520006,CDM,,,Facility,both,,,,539,269.5,,,,,,,,,,,,
Replicare Dressing 4 x 4,5520010,CDM,,,Facility,both,,,,5,2.5,,,,,,,,,,,,
Lock n Roll DraUltra-Cl w/Fi,5520012,CDM,,,Facility,both,,,,7,3.5,,,,,,,,,,,,
Wound Balancing Dressing,5520013,CDM,,,Facility,both,,,,27,13.5,,,,,,,,,,,,
Adapt Barrier Paste,5520014,CDM,,,Facility,both,,,,19,9.5,,,,,,,,,,,,
InterDry Ag Textile w/ Silver,5520015,CDM,,,Facility,both,,,,114,57,,,,,,,,,,,,
Trach tube-cuffed size 6,5520016,CDM,,,Facility,both,,,,13,6.5,,,,,,,,,,,,
Trach tube-cuffed size 8,5520017,CDM,,,Facility,both,,,,212,106,,,,,,,,,,,,
Silvercel non-adherent,5520018,CDM,,,Facility,both,,,,21,10.5,,,,,,,,,,,,
SPO2 Probe,5520019,CDM,,,Facility,both,,,,75,37.5,,,,,,,,,,,,
Bladder irrigation set,5520020,CDM,,,Facility,both,,,,60,30,,,,,,,,,,,,
Foley 16fr-3 way,5520021,CDM,,,Facility,both,,,,59,29.5,,,,,,,,,,,,
Foley 18fr-3 way,5520022,CDM,,,Facility,both,,,,59,29.5,,,,,,,,,,,,
Foley 20fr-3 way,5520023,CDM,,,Facility,both,,,,42,21,,,,,,,,,,,,
4L Drainage bag,5520024,CDM,,,Facility,both,,,,26,13,,,,,,,,,,,,
SOD CHLO IRR SOL 0.9% 3000ML,5520025,CDM,,,Facility,both,,,,114,57,,,,,,,,,,,,
"SYRINGE, INSULIN 0.5ML SAFETY",5520026,CDM,,,Facility,both,,,,10,5,,,,,,,,,,,,
TOILET SEAT RISER,5520027,CDM,,,Facility,both,,,,56,28,,,,,,,,,,,,
SUCTION TUBING CTRL VENT 12 FR,5520028,CDM,,,Facility,both,,,,16,8,,,,,,,,,,,,
SUCTION TUBING CTRL VENT 8 FR,5520029,CDM,,,Facility,both,,,,15,7.5,,,,,,,,,,,,
NASAL SPECULUM,5520030,CDM,,,Facility,both,,,,11,5.5,,,,,,,,,,,,
EAR FORCEPS,5520031,CDM,,,Facility,both,,,,10,5,,,,,,,,,,,,
CANNULA ADULT 14' TUBE S TO,5520032,CDM,,,Facility,both,,,,5,2.5,,,,,,,,,,,,
CATH SUCTION KIT 12 FR W/ H20,5520033,CDM,,,Facility,both,,,,15,7.5,,,,,,,,,,,,
QUIKCLOT 4 X 4,5520034,CDM,,,Facility,both,,,,126,63,,,,,,,,,,,,
CONTIN FLOW MED SET 3 PORT,5520035,CDM,,,Facility,both,,,,37,18.5,,,,,,,,,,,,
"SYRINGE, INSULIN 0.3ML",5520036,CDM,,,Facility,both,,,,10,5,,,,,,,,,,,,
"SYRINGE, LUER LOCK 1ML",5520037,CDM,,,Facility,both,,,,14,7,,,,,,,,,,,,
HYDORFERA BLUE,5520038,CDM,,,Facility,both,,,,194.78,97.39,,,,,,,,,,,,
18FR SALEM SUMP,5520039,CDM,,,Facility,both,,,,20.46,10.23,,,,,,,,,,,,
DRAPE FENES DISPBLE,5520040,CDM,,,Facility,both,,,,14.48,7.24,,,,,,,,,,,,
SKIN STAPLER,5520042,CDM,,,Facility,both,,,,42,21,,,,,,,,,,,,
Tx TarsalBone Fx w/o M Ea28450,5544266,CDM,28450,CPT,Facility,both,,,,1042.56,521.28,,,,,,,,,,,,
ACYCLOVIR TAB  400MG,5600008,CDM,J8499,HCPCS,Facility,outpatient,,,,6,3,,,,,,,,,,,,
lisinopriL 20 MG TABLET,5600010,CDM,J8499,HCPCS,Facility,outpatient,,,,5,2.5,,,,,,,,,,,,
Bacitracin,5600012,CDM,H0033,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
Baclofen 10mg,5600013,CDM,J1070,HCPCS,Facility,outpatient,,,,4.44,2.22,,,,,,,,,,,,
fluPHENAZine TAB 5MG,5600014,CDM,J2266,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
Prevnar 13 Syringe,5600017,CDM, J7302,HCPCS,Facility,outpatient,,,,779,389.5,,,,,,,,,,,,
PROLIA 60 MG/ML,5600018,CDM, J0897,HCPCS,Facility,outpatient,,,,2949.45,1474.73,,,,,,,,,,,,
ASA EC TAB 325MG,5600025,CDM,J1016,HCPCS,Facility,outpatient,,,,7.5,3.75,,,,,,,,,,,,
ZOSYN 3.375GM /NS 100ML  IVPB,5600045,CDM, J8499,HCPCS,Facility,inpatient,,,,10,5,,,,,,,,,,,,
VANCOMYCIN 1GM / NS 250ML,5600046,CDM, J3430,HCPCS,Facility,inpatient,,,,96.25,48.13,,,,,,,,,,,,
Duloxetine 60 mg,5600047,CDM,J2400,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
dilTIAZem DRIP 125MG / 125ML,5600048,CDM,J2150,HCPCS,Facility,both,,,,68.25,34.13,,,,,,,,,,,,
TENECTEPLASE INJ KIT 50MG,5600073,CDM, J3488,HCPCS,Facility,inpatient,,,,10500,5250,,,,,,,,,,,,
DIVALPROEX SOD DR 125MG CAP,5600082,CDM,J2220,HCPCS,Facility,outpatient,,,,6,3,,,,,,,,,,,,
PHENYTOIN SUSP 125MG/5ML,5600088,CDM, J2501,HCPCS,Facility,outpatient,,,,15,7.5,,,,,,,,,,,,
VENOFER 200MG / NS 100ML,5600106,CDM, J1756,HCPCS,Facility,outpatient,,,,143,71.5,,,,,,,,,,,,
Duo-Neb 0.5-3(2.5) MG/3 ML,5600122,CDM,J2420,HCPCS,Facility,both,,,,4,2,,,,,,,,,,,,
MAGNESIUM SULFATE INJ 1GM/2ML,5600145,CDM, J0135,HCPCS,Facility,both,,,,52.57,26.29,,,,,,,,,,,,
IRON POLYSACCH CAP 150MG,5600197,CDM,J2363,HCPCS,Facility,outpatient,,,,15,7.5,,,,,,,,,,,,
CARISOPRODOL TAB  350MG,5600250,CDM,J1310,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
KETOTIFEN  0.25% OPHTH SOL 5ML,5600264,CDM,S0013,HCPCS,Facility,outpatient,,,,20,10,,,,,,,,,,,,
CIPROFLOX  0.3% OPHTH 2.5ML,5600323,CDM,J1570,HCPCS,Facility,outpatient,,,,84,42,,,,,,,,,,,,
LEVOTHYROXINE CAP 150 MCG,5600341,CDM,J8499,HCPCS,Facility,outpatient,,,,5.25,2.63,,,,,,,,,,,,
"Creon DR 12,000 UNITS CAPSULE",5600419,CDM,J1760,HCPCS,Facility,outpatient,,,,26.75,13.38,,,,,,,,,,,,
EXTROAMPHETAMINE ER CAP 15MG,5600422,CDM,J2231,HCPCS,Facility,outpatient,,,,15,7.5,,,,,,,,,,,,
HYDROXYZINE PAMOATE 25mg,5600423,CDM,J2338,HCPCS,Facility,outpatient,,,,3.99,2,,,,,,,,,,,,
VALPROIC ACID SOLUTION 250mg/5ml,5600424,CDM,J8499,HCPCS,Facility,outpatient,,,,12.08,6.04,,,,,,,,,,,,
VANCOMYCIN 1.25GM / NS 250ML,5600451,CDM, J3430,HCPCS,Facility,inpatient,,,,90.48,45.24,,,,,,,,,,,,
GLUCERNA 1.0CAL 240ML,5600462,CDM,J2289,HCPCS,Facility,outpatient,,,,23.5,11.75,,,,,,,,,,,,
Diprolene,5600465,CDM,J2210,HCPCS,Facility,both,,,,156.25,78.13,,,,,,,,,,,,
HYDROcodone/Ibu 7.5-200MG,5600531,CDM,J2325,HCPCS,Facility,both,,,,56.75,28.38,,,,,,,,,,,,
TRAVOPROST 0.004% OPHTH SOL,5600552,CDM, J7316,HCPCS,Facility,outpatient,,,,26.72,13.36,,,,,,,,,,,,
ACYCLOVIR CAP 200MG,5601005,CDM,J8499,HCPCS,Facility,outpatient,,,,7.65,3.83,,,,,,,,,,,,
Albuterol Sulfate,5601007,CDM,J7613,HCPCS,Facility,outpatient,,,,7,3.5,,,,,,,,,,,,
ALLOPURINOL TAB 100MG,5601009,CDM,J8499,HCPCS,Facility,outpatient,,,,5,2.5,,,,,,,,,,,,
ALPRAZolam TAB 0.25MG,5601010,CDM,"	J8499",HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
AMIODARONE TAB 200MG,5601014,CDM,J8499,HCPCS,Facility,outpatient,,,,5,2.5,,,,,,,,,,,,
AMITRIPTYLINE TAB 25MG,5601016,CDM,J8499,HCPCS,Facility,outpatient,,,,3.5,1.75,,,,,,,,,,,,
amLODIPine TAB 5MG,5601017,CDM,J8499,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
AMOXICILLIN CAP 250MG,5601021,CDM,J8499,HCPCS,Facility,outpatient,,,,5,2.5,,,,,,,,,,,,
Augmentin 400-57 MG/5 ML SUSP,5601025,CDM,J1045,HCPCS,Facility,outpatient,,,,26.5,13.25,,,,,,,,,,,,
ARTIFICIAL TEARS OPHTH SOLN,5601046,CDM,J0001,HCPCS,Facility,outpatient,,,,1.2,0.6,,,,,,,,,,,,
ASA SUPP 300MG,5601048,CDM,1017,HCPCS,Facility,outpatient,,,,10.2,5.1,,,,,,,,,,,,
ATENOLOL TAB 50MG,5601054,CDM,1020,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
ATORVASTATIN TAB 10MG,5601055,CDM,1021,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
ATROPINE 1% OPHTH SOLN 2ML,5601056,CDM,J1020,HCPCS,Facility,outpatient,,,,15,7.5,,,,,,,,,,,,
AZITHROMYCIN TAB 250MG,5601060,CDM,J1065,HCPCS,Facility,outpatient,,,,9.5,4.75,,,,,,,,,,,,
BENZOIN COMPND 2OZ,5601067,CDM,J1090,HCPCS,Facility,outpatient,,,,56.5,28.25,,,,,,,,,,,,
Cogentin,5601068,CDM,J1690,HCPCS,Facility,outpatient,,,,6.67,3.34,,,,,,,,,,,,
BISACODYL SUPP 10MG,5601072,CDM,J1105,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
BISACODYL TAB 5MG,5601073,CDM,J1110,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
CALCIUM/VIT D  TAB 500MG/200IU,5601076,CDM,J1250,HCPCS,Facility,outpatient,,,,241.38,120.69,,,,,,,,,,,,
carBAMazepine  200MG TAB,5601079,CDM,J1270,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
DOXAZOSIN TAB 2MG,5601083,CDM,J2330,HCPCS,Facility,outpatient,,,,6.5,3.25,,,,,,,,,,,,
celeCOXIB CAP 100MG,5601092,CDM,J1440,HCPCS,Facility,outpatient,,,,59.5,29.75,,,,,,,,,,,,
CEPHALEXIN CAP 250MG,5601096,CDM,J1460,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
CLARITHROMYCIN TAB 500MG,5601107,CDM,J1580,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
CATAPRES-TTS 1,5601111,CDM,J1360,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
CLOTRIMAZOLE 1% CREAM 28.35G,5601112,CDM,J1670,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
COLCHICINE 0.6MG TAB,5601114,CDM,J1700,HCPCS,Facility,outpatient,,,,10,5,,,,,,,,,,,,
COLYTE PREP,5601115,CDM,J1730,HCPCS,Facility,outpatient,,,,100,50,,,,,,,,,,,,
CON ESTROG TAB 0.625MG,5601117,CDM,J1740,HCPCS,Facility,outpatient,,,,6,3,,,,,,,,,,,,
Losartan Potassium,5601118,CDM,J8499,HCPCS,Facility,outpatient,,,,4.25,2.13,,,,,,,,,,,,
LOSARTAN TAB 50MG,5601119,CDM,J8499,HCPCS,Facility,outpatient,,,,5,2.5,,,,,,,,,,,,
CYCLOBENZAPRINE TAB 10MG,5601120,CDM,J1790,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
DEXAMETHASONE  2 MG TAB,5601125,CDM,J1710,HCPCS,Facility,outpatient,,,,5,2.5,,,,,,,,,,,,
DEXAMETHASONE TAB 4MG,5601126,CDM,J1720,HCPCS,Facility,outpatient,,,,7.5,3.75,,,,,,,,,,,,
diazePAM TAB 5MG,5601129,CDM,J2040,HCPCS,Facility,outpatient,,,,6,3,,,,,,,,,,,,
DICYCLOMINE CAP 10MG,5601130,CDM,J2080,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
DILTIAZEM 24HR ER (CD),5601136,CDM,J2130,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
dilTIAZem ER  CAP 180MG,5601137,CDM,J2160,HCPCS,Facility,outpatient,,,,3.25,1.63,,,,,,,,,,,,
diphenhydrAMINE LIQ 12.5MG/5ML,5601140,CDM,J2190,HCPCS,Facility,outpatient,,,,20.25,10.13,,,,,,,,,,,,
DIPHENHYDRAMINE CAP 25MG,5601141,CDM,J2170,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
DOCUSATE CAP 100MG,5601146,CDM,J2260,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
DOCUSATE LIQ UD 100MG/10ML,5601148,CDM,J2270,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
DOXEPIN CAP 25MG,5601149,CDM,J2340,HCPCS,Facility,outpatient,,,,6.5,3.25,,,,,,,,,,,,
Doxycyc Mono 100 MG,5601151,CDM,J2360,HCPCS,Facility,outpatient,,,,15,7.5,,,,,,,,,,,,
ENALAPRIL TAB 10MG,5601155,CDM,J2190,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
ERYTHROMYCIN OPHTH OINT 0.5%,5601162,CDM,J2225,HCPCS,Facility,both,,,,22,11,,,,,,,,,,,,
FAMOTIDINE TAB 20MG,5601165,CDM,J2236,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
FAMCICLOVIR TAB 500MG,5601166,CDM,J2234,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
FERROUS SULFATE  TAB 325MG,5601167,CDM,J2251,HCPCS,Facility,outpatient,,,,4,2,,,,,,,,,,,,
FERROUS SULFATE ELIX300MG/5ML,5601168,CDM,J2252,HCPCS,Facility,outpatient,,,,6,3,,,,,,,,,,,,
FLUTICASONE INH 220MCG,5601172,CDM,J2272,HCPCS,Facility,both,,,,108,54,,,,,,,,,,,,
Umeclidinium Brm PU,5601173,CDM,J8499,HCPCS,Facility,outpatient,,,,52.5,26.25,,,,,,,,,,,,
FLUoxetine CAP 20MG,5601174,CDM,J2265,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
FOLIC ACID TAB 1MG,5601175,CDM,J2273,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
glipiZIDE TAB 5MG,5601179,CDM,J2287,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
glipiZIDE ER TAB  5MG,5601182,CDM,J2286,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
GLUCOSE (15GM) ORAL GEL,5601183,CDM,J2292,HCPCS,Facility,both,,,,23.75,11.88,,,,,,,,,,,,
GLYBURIDE TAB 3MG,5601185,CDM,J2293,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
GLYCERIN PEDIATRIC SUPP,5601187,CDM,J2296,HCPCS,Facility,both,,,,3,1.5,,,,,,,,,,,,
HALOPERIDOL TAB 0.5MG,5601200,CDM,J2305,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
HALOPERIDOL TAB 5MG,5601201,CDM,J2307,HCPCS,Facility,outpatient,,,,6.25,3.13,,,,,,,,,,,,
Haloperidol Decanoate Inj 100mg/ml SDV,5601202,CDM,J2303,HCPCS,Facility,both,,,,264,132,,,,,,,,,,,,
HYDROCHLOROTHIAZIDE TAB 25MG,5601203,CDM,J2323,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
hydrALAZINE TAB 25MG,5601205,CDM,J2321,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
HYDROcod-APAP TAB 5-325MG,5601207,CDM,J2324,HCPCS,Facility,both,,,,7.5,3.75,,,,,,,,,,,,
HYDROmorphone TAB 2MG,5601208,CDM,J2331,HCPCS,Facility,outpatient,,,,15.25,7.63,,,,,,,,,,,,
Methadone 10 mg tab,5601209,CDM,J1230,HCPCS,Facility,both,,,,45,22.5,,,,,,,,,,,,
hydrOXYzine HCL TAB 25MG,5601210,CDM,J2337,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
IBUPROFEN TAB 400 MG,5601213,CDM,J2343,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
IBUPROFEN TAB 600 MG,5601214,CDM,J2344,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
ISOSORBIDE MONO  TAB  30MG,5601218,CDM,J2365,HCPCS,Facility,outpatient,,,,3.25,1.63,,,,,,,,,,,,
INDOMETHACIN CAP 25MG,5601220,CDM,J2346,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
ISOSORBIDE MONO TAB  10MG,5601229,CDM,J2366,HCPCS,Facility,outpatient,,,,5,2.5,,,,,,,,,,,,
LIDOC 2% VISCOUS SOL 15 ML,5601246,CDM,J2001,HCPCS,Facility,both,,,,8.25,4.13,,,,,,,,,,,,
LISINOPRIL TAB 10MG,5601247,CDM,J8499,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
LOPERAMIDE CAP 2MG,5601249,CDM,J8499,HCPCS,Facility,outpatient,,,,5.5,2.75,,,,,,,,,,,,
LORATADINE TAB 10 MG,5601250,CDM,J8499,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
LORazepam TAB 0.5MG,5601251,CDM,J2060,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
LORazepam TAB 1MG,5601252,CDM,J2060,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
MEGACE TAB 40MG,5601262,CDM,J2100,HCPCS,Facility,both,,,,12,6,,,,,,,,,,,,
ENTRESTO 24-26 MG TAB,5601283,CDM,J2216,HCPCS,Facility,outpatient,,,,6,3,,,,,,,,,,,,
GABAPENTIN CAP 300MG,5601290,CDM,J2279,HCPCS,Facility,outpatient,,,,200.5,100.25,,,,,,,,,,,,
NITROGLYCERIN 0.2MG/HR PATCH,5601296,CDM,J2001,HCPCS,Facility,outpatient,,,,16.5,8.25,,,,,,,,,,,,
NITROGLYCERIN  0.4MG/HR PATCH,5601299,CDM,J2001,HCPCS,Facility,outpatient,,,,6.75,3.38,,,,,,,,,,,,
CLOPIDOGREL TAB 75MG,5601316,CDM,J1660,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
COLLAGENASE 250U/GM OINT 30G,5601349,CDM,J1720,HCPCS,Facility,outpatient,,,,1097,548.5,,,,,,,,,,,,
TOBRAMYCIN 0.3% OPHTH SOLN,5601382,CDM,J1094,HCPCS,Facility,outpatient,,,,4.5,2.25,,,,,,,,,,,,
LATANOPROST 0.005% OPTH SOL,5601396,CDM,J8499,HCPCS,Facility,outpatient,,,,15,7.5,,,,,,,,,,,,
AZITHROMYCIN  SUSP 200/5 15ML,5601400,CDM,J1055,HCPCS,Facility,outpatient,,,,70,35,,,,,,,,,,,,
SOD FERRIC GLUC 125MG/NS 100ML,5603019,CDM,J1439,HCPCS,Facility,outpatient,,,,191,95.5,,,,,,,,,,,,
LACTOBACIL ACID/BULGARICUS TB,5603091,CDM,S0174,HCPCS,Facility,outpatient,,,,11.25,5.63,,,,,,,,,,,,
INSULIN GLARG(LANTUS INJ 5 U,5603136,CDM,J2350,HCPCS,Facility,both,,,,11.5,5.75,,,,,,,,,,,,
INSULIN HumaLOG 75/25 INJ  5 U,5603137,CDM,J2351,HCPCS,Facility,both,,,,15,7.5,,,,,,,,,,,,
INSULIN(HumuLIN 70/30)INJ  5U,5603140,CDM,J2358,HCPCS,Facility,both,,,,11.25,5.63,,,,,,,,,,,,
INSULIN NPH (HumuLIN N)INJ 5 U,5603141,CDM,J2355,HCPCS,Facility,both,,,,15,7.5,,,,,,,,,,,,
INSULIN NPH (HUMULIN N),5603142,CDM,J2354,HCPCS,Facility,both,,,,11.5,5.75,,,,,,,,,,,,
INSULIN LISPRO (HUMALOG),5603143,CDM,J2353,HCPCS,Facility,both,,,,37.5,18.75,,,,,,,,,,,,
Activase,5640019,CDM,J2860,HCPCS,Facility,outpatient,,,,9800.5,4900.25,,,,,,,,,,,,
Apixaban 2.5 MG TABLET,5640022,CDM,34066,HCPCS,Facility,outpatient,,,,58.25,29.13,,,,,,,,,,,,
Apixaban 5 MG TABLET,5640023,CDM,34067,HCPCS,Facility,outpatient,,,,58.25,29.13,,,,,,,,,,,,
VANCOMYCIN 2GM / NS 500ML,5640024,CDM,J3430,HCPCS,Facility,inpatient,,,,150,75,,,,,,,,,,,,
VANCOMYCIN 750MG / NS 250ML,5640027,CDM,J3430,HCPCS,Facility,inpatient,,,,66.5,33.25,,,,,,,,,,,,
CLINDAMYCIN 900MG/ NS 100ML,5640028,CDM,J1610,HCPCS,Facility,outpatient,,,,72.22,36.11,,,,,,,,,,,,
KETOROLAC PO,5640038,CDM,S0183,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
LINACOLTIDE CAP 290 MCG,5640042,CDM,J8499,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
PIP/TAZO  2.25GM / NS 100ML,5640047,CDM,J8499,HCPCS,Facility,outpatient,,,,32,16,,,,,,,,,,,,
PIP/TAZO  4.5GM / NS 100ML,5640048,CDM,J8499,HCPCS,Facility,outpatient,,,,32,16,,,,,,,,,,,,
PANTOPRAZOLE 40MG / NS 100ML,5640071,CDM,J8499,HCPCS,Facility,outpatient,,,,35,17.5,,,,,,,,,,,,
ADENOSINE INJ 6MG/2ML,5640073,CDM,J0151,HCPCS,Facility,outpatient,,,,77,38.5,,,,,,,,,,,,
APAP LIQ UD CUP 325MG/10.15ML,5641009,CDM,J1030,HCPCS,Facility,outpatient,,,,0.62,0.31,,,,,,,,,,,,
APAP PED SUSP UD 160MG/5ML,5641010,CDM,J1040,HCPCS,Facility,outpatient,,,,1.2,0.6,,,,,,,,,,,,
ACETYLCYSTEINE 20% ORAL 30ML,5641013,CDM,J8499,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
ACTIVATED CHARC-AQUA 50G/240ML,5641015,CDM,A4206,HCPCS,Facility,outpatient,,,,113.25,56.63,,,,,,,,,,,,
ACTIDOSE-AQUA PED 25GM/120ML,5641016,CDM,J8499,HCPCS,Facility,outpatient,,,,23.45,11.73,,,,,,,,,,,,
FLUTICA/SALMET DISK 100/50MCG,5641024,CDM,J2267,HCPCS,Facility,both,,,,41.5,20.75,,,,,,,,,,,,
FLUTICA/SALMET DISK 250/50MCG,5641025,CDM,J2268,HCPCS,Facility,both,,,,41.5,20.75,,,,,,,,,,,,
FLUTICA/SALMET DISK 500/50MCG,5641026,CDM,J2269,HCPCS,Facility,both,,,,41.5,20.75,,,,,,,,,,,,
Albuterol Sulfate HFA 90 MCG,5641033,CDM,J7608,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
AMIODARONE INJ 150MG/3ML,5641052,CDM,J0170,HCPCS,Facility,outpatient,,,,26.84,13.42,,,,,,,,,,,,
AMOX SUSP 100ML  200MG/5ML,5641056,CDM,J8499,HCPCS,Facility,outpatient,,,,5.25,2.63,,,,,,,,,,,,
AMPICILLIN INJ 1GM VIAL,5641060,CDM,250,HCPCS,Facility,outpatient,,,,48.5,24.25,,,,,,,,,,,,
DONEPEZIL TAB 5 MG,5641076,CDM,J2290,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
ANASTROZOLE 1MG TAB,5641077,CDM,1003,HCPCS,Facility,outpatient,,,,20.12,10.06,,,,,,,,,,,,
ATROPINE SULFAT IN  0.4 MG/ML,5641087,CDM,J1030,HCPCS,Facility,outpatient,,,,56,28,,,,,,,,,,,,
ATROPINE INJ 1MG/10ML SYRINGE,5641088,CDM,J1025,HCPCS,Facility,outpatient,,,,15,7.5,,,,,,,,,,,,
IPRATROPIUM  INH 17MCG,5641089,CDM,J2361,HCPCS,Facility,both,,,,3,1.5,,,,,,,,,,,,
DICYCLOMINE 20MG/2ML INJ,5641107,CDM,J2070,HCPCS,Facility,both,,,,120,60,,,,,,,,,,,,
BENZONATATE  CAP 100MG,5641108,CDM,J1095,HCPCS,Facility,outpatient,,,,4,2,,,,,,,,,,,,
PEN G BENZ/PRO  1.2MMU/2ML SYR,5641114,CDM,J1499,HCPCS,Facility,outpatient,,,,25,12.5,,,,,,,,,,,,
WELLBUTRIN XL TAB,5641134,CDM,J8499,HCPCS,Facility,outpatient,,,,12,6,,,,,,,,,,,,
CALCITRIOL CAP 0.25 MCG,5641141,CDM,J1230,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
CALC CHL 10% INJ SYR 1G/10ML,5641143,CDM,J1210,HCPCS,Facility,outpatient,,,,15,7.5,,,,,,,,,,,,
FUROSEMIDE TAB 40MG,5641144,CDM,J2278,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
CALMOSEPTINE  OINT 113GM,5641146,CDM,J1260,HCPCS,Facility,outpatient,,,,30,15,,,,,,,,,,,,
CARBIDOPA/LEVODOPA TB 25/100MG,5641152,CDM,J1280,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
CLONIDINE TTS 3 PATCH,5641159,CDM,J1650,HCPCS,Facility,outpatient,,,,363,181.5,,,,,,,,,,,,
CLONIDINE TTS 2 PATCH,5641160,CDM,J1640,HCPCS,Facility,outpatient,,,,363,181.5,,,,,,,,,,,,
CEFTRIAXONE  INJ 1GM VIAL,5641166,CDM,J1400,HCPCS,Facility,outpatient,,,,105,52.5,,,,,,,,,,,,
CEFTRIAXONE INJ 2GM,5641169,CDM,J1410,HCPCS,Facility,outpatient,,,,210,105,,,,,,,,,,,,
CEFTRIAXONE INJ 500MG,5641170,CDM,J1420,HCPCS,Facility,outpatient,,,,52.5,26.25,,,,,,,,,,,,
CEPACOL THROAT SPRAY 177ML,5641177,CDM,J1450,HCPCS,Facility,outpatient,,,,31.25,15.63,,,,,,,,,,,,
CEPHALEXIN250MG/5ML,5641178,CDM,J1470,HCPCS,Facility,outpatient,,,,15,7.5,,,,,,,,,,,,
CHLORDIAZEP CAP 25MG,5641186,CDM,J1490,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
CHLORDIAZEP CAP 5MG,5641187,CDM,J1500,HCPCS,Facility,outpatient,,,,3.5,1.75,,,,,,,,,,,,
CHLORPROMAZINE  IM INJ 25MG,5641190,CDM,J1520,HCPCS,Facility,outpatient,,,,18,9,,,,,,,,,,,,
chlorproMAZINE  TAB 25MG,5641191,CDM,J1530,HCPCS,Facility,outpatient,,,,9,4.5,,,,,,,,,,,,
CHOLESTYRAMINE 4 GM,5641192,CDM,J1560,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
CLINDAMYCIN CAP 150MG,5641201,CDM,J1620,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
CLINDAMYCIN INJ 300MG/2ML,5641202,CDM,J1630,HCPCS,Facility,outpatient,,,,15,7.5,,,,,,,,,,,,
DORZOL/TIMOLOL OPTH SOLN 10ML,5641223,CDM,J2310,HCPCS,Facility,both,,,,32,16,,,,,,,,,,,,
CYANOCOBALAMIN INJ 1MG/ML,5641230,CDM,J1770,HCPCS,Facility,outpatient,,,,48.5,24.25,,,,,,,,,,,,
DULoxetine CAP 30MG,5641235,CDM,J2410,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
D5NS + 40MEQ KCL 1000ML,5641239,CDM,J1840,HCPCS,Facility,outpatient,,,,63,31.5,,,,,,,,,,,,
DAKIN'S SOL 0.125%  480ML,5641240,CDM,J2180,HCPCS,Facility,outpatient,,,,83.75,41.88,,,,,,,,,,,,
DIVALPROEX SOD DR 250MG TAB,5641251,CDM,J2230,HCPCS,Facility,outpatient,,,,11.25,5.63,,,,,,,,,,,,
DIVALPROEX SOD DR TAB 500MG,5641252,CDM,J2240,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
DEXAMETHASONE VIAL 4MG/ML,5641263,CDM,J1670,HCPCS,Facility,both,,,,19.75,9.88,,,,,,,,,,,,
DEXTROSE 10% 1000ML,5641264,CDM,J1900,HCPCS,Facility,both,,,,60,30,,,,,,,,,,,,
DEXTROSE 25% INJ 10ML SYR,5641265,CDM,J1910,HCPCS,Facility,both,,,,60,30,,,,,,,,,,,,
DEXTROSE 50% SYR INJ 25GM/50ML,5641266,CDM,J2000,HCPCS,Facility,both,,,,60.75,30.38,,,,,,,,,,,,
diazePAM  INJ 10MG/2ML,5641267,CDM,J2010,HCPCS,Facility,both,,,,74,37,,,,,,,,,,,,
diazePAM TAB 2MG,5641268,CDM,J2030,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
DICLOFENACE 75MG,5641271,CDM,J2060,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
DICYCLOMINE SYRUP 10MG/5ML,5641273,CDM,J2090,HCPCS,Facility,outpatient,,,,234,117,,,,,,,,,,,,
FLUCONAZOLE TAB 100MG,5641274,CDM,J2260,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
dilTIAZem 25MG/5ML INJ VIAL,5641283,CDM,J2140,HCPCS,Facility,both,,,,24.5,12.25,,,,,,,,,,,,
dilTIAZem  TAB 30MG,5641286,CDM,J2110,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
diphenhydrAMINE INJ 50MG/ML,5641294,CDM,J2180,HCPCS,Facility,both,,,,20.75,10.38,,,,,,,,,,,,
DOBUTAMINE BAG IV 250MG/250ML,5641300,CDM,J2250,HCPCS,Facility,both,,,,123.6,61.8,,,,,,,,,,,,
DOPamine 400 MG/250 ML-D5W,5641303,CDM,J2300,HCPCS,Facility,both,,,,78.18,39.09,,,,,,,,,,,,
DOXYCYCLINE INJ 100MG/20ML INJ,5641308,CDM,J2380,HCPCS,Facility,both,,,,94.06,47.03,,,,,,,,,,,,
fentaNYL 75MCG/HR PATCH,5641310,CDM,J2249,HCPCS,Facility,both,,,,100,50,,,,,,,,,,,,
ENALAPRILAT INJ 1.25MG/ML,5641326,CDM,J2197,HCPCS,Facility,both,,,,22,11,,,,,,,,,,,,
ENALAPRIL TAB 5MG,5641327,CDM,J2195,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
EPINEPHr 0.1% AMP 1MG/ML,5641330,CDM,J2219,HCPCS,Facility,both,,,,66,33,,,,,,,,,,,,
EPINEPHr  0.01% SYR 1MG/10ML,5641331,CDM,J2218,HCPCS,Facility,both,,,,15,7.5,,,,,,,,,,,,
EPIPEN JR 2-PAK,5641333,CDM,J2220,HCPCS,Facility,both,,,,1217.25,608.63,,,,,,,,,,,,
DEPO MEDROL 80MG,5641334,CDM,J1830,HCPCS,Facility,outpatient,,,,52.59,26.3,,,,,,,,,,,,
ETOMIDATE INJ 40MG/20ML,5641338,CDM,J2229,HCPCS,Facility,both,,,,38.5,19.25,,,,,,,,,,,,
Eye-Stream,5641348,CDM,J2232,HCPCS,Facility,outpatient,,,,20,10,,,,,,,,,,,,
Famotidine 20 MG/2 ML VIAL,5641351,CDM,J2235,HCPCS,Facility,both,,,,18.75,9.38,,,,,,,,,,,,
FentaNYL 100 MCG/2 ML VIAL,5641353,CDM,J2245,HCPCS,Facility,both,,,,15,7.5,,,,,,,,,,,,
fentaNYL  PATCH 50MCG/HR,5641359,CDM,J2244,HCPCS,Facility,both,,,,76.25,38.13,,,,,,,,,,,,
Ferrlecit 62.5 MG/5 ML VIAL,5641362,CDM,J2250,HCPCS,Facility,both,,,,50,25,,,,,,,,,,,,
APAP PEDIATRIC SUPP 120MG,5641363,CDM,J1050,HCPCS,Facility,outpatient,,,,1.2,0.6,,,,,,,,,,,,
FLUTICASONE 50MCG/SPRAY 16GM,5641372,CDM,J2270,HCPCS,Facility,both,,,,55,27.5,,,,,,,,,,,,
FLUDROCORTISONE  TAB 0.1MG,5641373,CDM,J2262,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
FLUoxetine CAP 10MG,5641379,CDM,J2264,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
FUROSEMIDE INJ 100MG/10ML,5641386,CDM,J2275,HCPCS,Facility,both,,,,23.25,11.63,,,,,,,,,,,,
FUROSEMIDE INJ 20MG/2ML,5641387,CDM,J2276,HCPCS,Facility,both,,,,15.75,7.88,,,,,,,,,,,,
FUROSEMIDE INJ 40MG/4ML,5641388,CDM,J2277,HCPCS,Facility,both,,,,21.75,10.88,,,,,,,,,,,,
GABAPENTIN CAP 400MG,5641389,CDM,J2280,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
GEMFIBROZIL TAB 600MG,5641391,CDM,J2282,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
GENTAMICIN INJ 80MG/2ML,5641394,CDM,J2284,HCPCS,Facility,both,,,,27.98,13.99,,,,,,,,,,,,
GENTAMICIN 0.3% OPTH SOL 5mL,5641395,CDM,J2283,HCPCS,Facility,both,,,,35,17.5,,,,,,,,,,,,
Isoton Gentamicin 80 MG/50 ML,5641396,CDM,J2367,HCPCS,Facility,both,,,,8,4,,,,,,,,,,,,
GLUCAGON INJ 1MG/ML,5641397,CDM,J2288,HCPCS,Facility,both,,,,686.5,343.25,,,,,,,,,,,,
GLYBURIDE TAB 5MG,5641402,CDM,J2294,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
GLYCERIN LIQUID 120ML,5641404,CDM,J2295,HCPCS,Facility,outpatient,,,,50,25,,,,,,,,,,,,
guaiFENesin  UD  100MG/5ML,5641407,CDM,J2298,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
guaiFENesin ER TAB 600MG,5641408,CDM,J2300,HCPCS,Facility,outpatient,,,,6.75,3.38,,,,,,,,,,,,
guaiFENesin DM UD 100-10MG/5mL,5641409,CDM,J2299,HCPCS,Facility,outpatient,,,,13.5,6.75,,,,,,,,,,,,
HALOPERIDOL TAB 2MG,5641411,CDM,J2306,HCPCS,Facility,outpatient,,,,6.25,3.13,,,,,,,,,,,,
HALOPERIDOL INJ 5MG/ML,5641412,CDM,J2304,HCPCS,Facility,both,,,,6.25,3.13,,,,,,,,,,,,
"HEPARIN INJ 1,000U/ML",5641418,CDM,J2311,HCPCS,Facility,both,,,,15,7.5,,,,,,,,,,,,
Heparin 500 UNIT/5 ML (100/ML),5641420,CDM,J2310,HCPCS,Facility,both,,,,15,7.5,,,,,,,,,,,,
humaLOG MIX 75-25 VIAL,5641428,CDM,J2314,HCPCS,Facility,both,,,,36.25,18.13,,,,,,,,,,,,
HURRICANE 20% SPRAY PER APP,5641430,CDM,J2318,HCPCS,Facility,both,,,,20,10,,,,,,,,,,,,
hydrALAZINE INJ 20MG/ML,5641432,CDM,J2319,HCPCS,Facility,both,,,,86,43,,,,,,,,,,,,
hydrALAZINE TAB 10 MG,5641433,CDM,J2320,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
HYDROMORPHONE INJ 2MG/ML,5641437,CDM,J2330,HCPCS,Facility,both,,,,15.25,7.63,,,,,,,,,,,,
HYDROXYUREA CAP 500MG,5641438,CDM,J2334,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
IBUPROFEN TAB 200 MG,5641443,CDM,J2342,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
IPRATROPIUM NEB 0.5MG/2.5ML,5641460,CDM,J2362,HCPCS,Facility,both,,,,3,1.5,,,,,,,,,,,,
LEVETIRACETAM TAB 500 MG,5641474.5,CDM,J8499,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
KETOCONAZOLE 2% CR 30G,5641475,CDM,J3490,HCPCS,Facility,outpatient,,,,58,29,,,,,,,,,,,,
KETOROLAC INJ  30MG/ML,5641478,CDM,J1885,HCPCS,Facility,both,,,,17.1,8.55,,,,,,,,,,,,
KETOROLAC INJ  60MG/2ML,5641479,CDM,J1885,HCPCS,Facility,both,,,,28.58,14.29,,,,,,,,,,,,
LABETALOL TAB  100 MG,5641483,CDM,S0187,HCPCS,Facility,outpatient,,,,3.5,1.75,,,,,,,,,,,,
LABETALOL INJ 100MG/20ML MDV,5641484,CDM,J2212,HCPCS,Facility,both,,,,98,49,,,,,,,,,,,,
LABETOLOL (bulk),5641485,CDM,J2212,HCPCS,Facility,both,,,,98,49,,,,,,,,,,,,
LACTULOSE ORAL SOL 20GM/30ML,5641487,CDM,J8499,HCPCS,Facility,outpatient,,,,3.75,1.88,,,,,,,,,,,,
LAMOTRIGINE TAB 200MG,5641488,CDM,J8499,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
INSULIN GLARG(LANTUS INJ  1U,5641489,CDM,J2349,HCPCS,Facility,both,,,,11.5,5.75,,,,,,,,,,,,
LANTUS SOLOSTAR PEN,5641490,CDM,J1815,HCPCS,Facility,both,,,,35,17.5,,,,,,,,,,,,
levoFLOXacin TAB 250MG,5641498,CDM,J7611,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
levoFLOXacin IV 250MG/50ML,5641499,CDM,J7611,HCPCS,Facility,both,,,,42,21,,,,,,,,,,,,
levoFLOXacin IV 750MG/150ML,5641501,CDM,J7611,HCPCS,Facility,both,,,,51,25.5,,,,,,,,,,,,
ESCITALOPRAM TAB 10 MG,5641508,CDM,J2226,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
LIDOCAINE 1% INJ 20ML MDV,5641513,CDM,J2001,HCPCS,Facility,both,,,,28.5,14.25,,,,,,,,,,,,
LIDOCAINE 1% INJ 20MG/2ML SDV,5641514,CDM,J2001,HCPCS,Facility,both,,,,20.25,10.13,,,,,,,,,,,,
LIDOCAINE 2% CARD 100MG/5ML,5641515,CDM,J2001,HCPCS,Facility,both,,,,42,21,,,,,,,,,,,,
LIDOCAINE 2% INJ MDV 20ML,5641516,CDM,J2001,HCPCS,Facility,both,,,,16,8,,,,,,,,,,,,
"LIDOC 2%EPI 1-100,000 IN 20ML",5641517,CDM,J2001,HCPCS,Facility,both,,,,28.5,14.25,,,,,,,,,,,,
LIDOCAINE 0.4% 2GM/D5W 500ML,5641518,CDM,J2001,HCPCS,Facility,both,,,,54.6,27.3,,,,,,,,,,,,
LICOCAINE 2% 100MG/5ML,5641519,CDM,J2001,HCPCS,Facility,both,,,,40.25,20.13,,,,,,,,,,,,
LIDOCAINE 2% TOP JELLY 5ML,5641520,CDM,J2001,HCPCS,Facility,both,,,,44.5,22.25,,,,,,,,,,,,
LIDOCAINE/EPI 2%,5641521,CDM,J2001,HCPCS,Facility,both,,,,28.5,14.25,,,,,,,,,,,,
LIDOCAINE 2% INJ 20 ML (BULK),5641522,CDM,J2001,HCPCS,Facility,both,,,,28.5,14.25,,,,,,,,,,,,
LIDOCAINE 5% PATCH,5641523,CDM,J2001,HCPCS,Facility,both,,,,22.5,11.25,,,,,,,,,,,,
FIRVANG 50MG/ML,5641524,CDM,J2257,HCPCS,Facility,outpatient,,,,135,67.5,,,,,,,,,,,,
LITHIUM CARBONATE CAP 300MG,5641526,CDM,J8499,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
LORAZEPAM  INJ 2MG/ML,5641531,CDM,J2060,HCPCS,Facility,both,,,,15,7.5,,,,,,,,,,,,
ENOXAPARIN  INJ 100MG/ML,5641536,CDM,J2210,HCPCS,Facility,both,,,,90,45,,,,,,,,,,,,
ENOXAPARIN  INJ 30MG/0.3ML,5641538,CDM,J2211,HCPCS,Facility,both,,,,42,21,,,,,,,,,,,,
ENOXAPARIN INJ 40MG/0.4ML,5641539,CDM,J2212,HCPCS,Facility,both,,,,55.75,27.88,,,,,,,,,,,,
ENOXAPARIN INJ 60MG/0.6ML,5641540,CDM,J2213,HCPCS,Facility,both,,,,71.75,35.88,,,,,,,,,,,,
ENOXAPARIN INJ 80MG/0.8ML,5641541,CDM,J2214,HCPCS,Facility,both,,,,95.5,47.75,,,,,,,,,,,,
MANNITOL 25% INJ  12.5GM/50ML,5641557,CDM,J7500,HCPCS,Facility,both,,,,114.3,57.15,,,,,,,,,,,,
DRONABINOL CAP 2.5MG,5641558,CDM,J2390,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
MEGESTROL 40MG/ML SUSP PER ML,5641565,CDM,J2100,HCPCS,Facility,both,,,,28.5,14.25,,,,,,,,,,,,
Dextrose 5%-0.2% Nacl IV Soln,5641566,CDM,J1940,HCPCS,Facility,both,,,,27.23,13.62,,,,,,,,,,,,
MEPERIDINE INJ 50MG/ML SYR,5641570,CDM,J0130,HCPCS,Facility,both,,,,30,15,,,,,,,,,,,,
methylPREDNISolone acetate,5641585,CDM,J2920,HCPCS,Facility,both,,,,61,30.5,,,,,,,,,,,,
methylPREDNISolone acetate,5641586,CDM,J2920,HCPCS,Facility,both,,,,61,30.5,,,,,,,,,,,,
METOPROLOL INJ 5MG/5ML,5641589,CDM,J1200,HCPCS,Facility,both,,,,15,7.5,,,,,,,,,,,,
metroNIDAZOLE  IV PREMIX 500MG,5641591,CDM,J0180,HCPCS,Facility,both,,,,17.18,8.59,,,,,,,,,,,,
CALCITONIN NASAL SPRAY 3.7ML,5641593,CDM,J1220,HCPCS,Facility,outpatient,,,,26.58,13.29,,,,,,,,,,,,
MIDAZOLAM INJ 2MG/2ML,5641599,CDM,J1120,HCPCS,Facility,both,,,,5,2.5,,,,,,,,,,,,
MORPHINE INJ 10MG/ML,5641614,CDM,J2270,HCPCS,Facility,both,,,,10.25,5.13,,,,,,,,,,,,
MORPHINE INJ 2MG/ML,5641615,CDM,J2270,HCPCS,Facility,both,,,,19.16,9.58,,,,,,,,,,,,
naLOXone SYRINGE INJ 2MG/2ML,5641636,CDM,J0401,HCPCS,Facility,inpatient,,,,75.54,37.77,,,,,,,,,,,,
naLOXone INJ 0.4MG/ML,5641638,CDM,J0401,HCPCS,Facility,inpatient,,,,95,47.5,,,,,,,,,,,,
NITROGLYCERIN 0.1MG/HR PATCH,5641674,CDM,J2001,HCPCS,Facility,outpatient,,,,16.5,8.25,,,,,,,,,,,,
LIP/PROTEASE/AMYLASE CAP 5000U,5641709,CDM,J8499,HCPCS,Facility,outpatient,,,,26.75,13.38,,,,,,,,,,,,
PCN G POT 5MIL/UN VIAL,5641725,CDM,J3300,HCPCS,Facility,outpatient,,,,18,9,,,,,,,,,,,,
PHENobarbital INJ 65MG,5641727,CDM,J1750,HCPCS,Facility,inpatient,,,,5,2.5,,,,,,,,,,,,
CALCIUM ACETATE CAP 667 MG,5641737,CDM,J1240,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
Piperacil-Tazobact 2.25 GM VL,5641745,CDM,J8499,HCPCS,Facility,outpatient,,,,38.5,19.25,,,,,,,,,,,,
FELODIPINE TAB 5MG,5641747,CDM,J2239,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
PNEUMOVAX 23 VAC 0.5ML,5641748,CDM, J1770,HCPCS,Facility,outpatient,,,,779,389.5,,,,,,,,,,,,
CONJUG ESTROGENS 0.3MG TAB,5641758,CDM,J1750,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
PROCHLORPERAZINE INJ 10MG/2ML,5641766,CDM, J1200,HCPCS,Facility,inpatient,,,,27.09,13.55,,,,,,,,,,,,
PROMETHAZINE  INJ 25MG/ML,5641774,CDM, J2250,HCPCS,Facility,inpatient,,,,10,5,,,,,,,,,,,,
Diprivan,5641784,CDM,J2200,HCPCS,Facility,both,,,,18,9,,,,,,,,,,,,
FINASTERIDE TAB 5MG,5641790,CDM,J2255,HCPCS,Facility,outpatient,,,,5,2.5,,,,,,,,,,,,
RABIES VACCINE 2.5UNITS/ML,5641804,CDM, J0702,HCPCS,Facility,outpatient,,,,1670.5,835.25,,,,,,,,,,,,
OCTREOTIDE INJ 100 MCG/ML,5641836,CDM, J3240,HCPCS,Facility,inpatient,,,,298.14,149.07,,,,,,,,,,,,
Bupivicaine 0.25% VIAL,5641842,CDM,J1190,HCPCS,Facility,outpatient,,,,25,12.5,,,,,,,,,,,,
METHYLPREDNISOLONE 1 GM,5641850,CDM, J2920,HCPCS,Facility,outpatient,,,,314.28,157.14,,,,,,,,,,,,
CARBIDOPA/LEVODOPA TB 25/250MG,5641851,CDM,J1290,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
SOD BICARB 8.4% INJ0MEQ/50ML,5641859,CDM, J1746,HCPCS,Facility,outpatient,,,,71.5,35.75,,,,,,,,,,,,
1/2 NS + 20MEQ KCL 1000ML,5641864,CDM,J7050,HCPCS,Facility,outpatient,,,,65,32.5,,,,,,,,,,,,
SOD BICARB 8.4% SYR 50MEQ/50ML,5641865,CDM, J1746,HCPCS,Facility,outpatient,,,,71.5,35.75,,,,,,,,,,,,
HYDROCORTISONE INJ 100MG,5641871,CDM,J2328,HCPCS,Facility,both,,,,35,17.5,,,,,,,,,,,,
methyLPRED INJ 125MG,5641873,CDM, J2920,HCPCS,Facility,both,,,,68.25,34.13,,,,,,,,,,,,
methylPREDNISolone  INJ 40 MG,5641874,CDM, J2920,HCPCS,Facility,both,,,,42.5,21.25,,,,,,,,,,,,
methylPREDNISolone INJ 500 MG,5641876,CDM, J2920,HCPCS,Facility,both,,,,72,36,,,,,,,,,,,,
TIOTROPIUM 18MCG CAP W/DEVICE,5641879,CDM, J8499,HCPCS,Facility,outpatient,,,,5,2.5,,,,,,,,,,,,
SUCCINYLCHOL  MDV PER 20MG,5641887,CDM, J3280,HCPCS,Facility,inpatient,,,,42,21,,,,,,,,,,,,
LEVOTHYROXINE TAB 112MCG,5641898,CDM,J8499,HCPCS,Facility,outpatient,,,,4.5,2.25,,,,,,,,,,,,
TERBUTALINE INJ 1MG/ML,5641911,CDM, J8499,HCPCS,Facility,outpatient,,,,45.25,22.63,,,,,,,,,,,,
TETANUS/DIPHTH 0.5ML,5641914,CDM, J1800,HCPCS,Facility,outpatient,,,,163.25,81.63,,,,,,,,,,,,
ADACEL VACCINE 0.5ML INJ AGE7+,5641916,CDM,"	90715",HCPCS,Facility,outpatient,,,,289.5,144.75,,,,,,,,,,,,
THIAMINE INJ 200MG/2ML,5641921,CDM, J1650,HCPCS,Facility,outpatient,,,,37.5,18.75,,,,,,,,,,,,
TRIAMCINOLONE MDV 50MG/5ML,5641945,CDM, J3300,HCPCS,Facility,outpatient,,,,125.75,62.88,,,,,,,,,,,,
Fenofib Nanocryst 145 MG,5641950,CDM,J2240,HCPCS,Facility,outpatient,,,,6,3,,,,,,,,,,,,
ALFUZOSIN ER TAB 10MG,5641969,CDM,"	J8499",HCPCS,Facility,outpatient,,,,6,3,,,,,,,,,,,,
VANCOMYCIN INJ 1GM/20ML VIAL,5641972,CDM, J3430,HCPCS,Facility,inpatient,,,,96.25,48.13,,,,,,,,,,,,
VECURONIUM INJ 20MG/20ML,5641976,CDM, J1250,HCPCS,Facility,inpatient,,,,62,31,,,,,,,,,,,,
IRON SUCROSE  INJ 100MG/5ML,5641979,CDM,J2364,HCPCS,Facility,both,,,,143,71.5,,,,,,,,,,,,
CYANOCOBALAMIN TAB 250MCG,5641988,CDM,J1780,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
Ergocalc VitD2 1250 MG,5641991,CDM,J2222,HCPCS,Facility,outpatient,,,,12,6,,,,,,,,,,,,
LEVALBUTEROL NEB 0.63MG/3ML,5642002,CDM,J7605,HCPCS,Facility,both,,,,12,6,,,,,,,,,,,,
EZETIMIBE TAB 10MG,5642012,CDM,J2233,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
ONDANSETRON  INJ 4MG/2ML,5642017,CDM, J2405,HCPCS,Facility,inpatient,,,,15,7.5,,,,,,,,,,,,
PIPERACILLIN-TAZO IV 3.375GM,5642020,CDM, J8499,HCPCS,Facility,outpatient,,,,51.38,25.69,,,,,,,,,,,,
ACYCLOVIR INJ 500MG,5642022,CDM,J0696,HCPCS,Facility,outpatient,,,,6.5,3.25,,,,,,,,,,,,
LINEZOLID TAB : 600MG,5642029,CDM,J2020,HCPCS,Facility,outpatient,,,,3724.5,1862.25,,,,,,,,,,,,
Linezolid 600 MG/300 ML-D5W,5642030,CDM,J2020,HCPCS,Facility,both,,,,3724.5,1862.25,,,,,,,,,,,,
BRIMONIDINE  0.1% OP SOLN 5ML,5642077,CDM,J1120,HCPCS,Facility,outpatient,,,,196,98,,,,,,,,,,,,
ASA E.C. TAB 81MG,5642125,CDM,1015,HCPCS,Facility,outpatient,,,,7.5,3.75,,,,,,,,,,,,
ATENOLOL  TAB 25MG,5642135,CDM,1019,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
MOXIFLOXACIN IV 400MG/250ML,5642153,CDM, J0690,HCPCS,Facility,both,,,,125,62.5,,,,,,,,,,,,
Remdesivir (EUA),5642170,CDM, J8499,HCPCS,Facility,outpatient,,,,1520,760,,,,,,,,,,,,
IBANDRONATE TAB 150 MG,5642205,CDM,J2341,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
CARISOPRODOL  TB  250MG,5642266,CDM,J1300,HCPCS,Facility,outpatient,,,,1.5,0.75,,,,,,,,,,,,
LORATADINE/PSE 12HR TAB,5642338,CDM,J8499,HCPCS,Facility,outpatient,,,,15,7.5,,,,,,,,,,,,
COLESTIPOL TAB 1GM,5642357,CDM,J1710,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
Fluconazole-NACL 200 MG/100 ML,5642571,CDM,J2261,HCPCS,Facility,both,,,,3,1.5,,,,,,,,,,,,
FUROSEMIDE  TAB 20MG,5642591,CDM,J2274,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
ZIPRASIDONE INJ 20MG/ML,5642611,CDM, J2796,HCPCS,Facility,outpatient,,,,7,3.5,,,,,,,,,,,,
guaiFENesin/COD UD100-10MG/5ML,5642628,CDM,J2301,HCPCS,Facility,outpatient,,,,4.5,2.25,,,,,,,,,,,,
HEPARIN INJ 5000UNITS/1ML,5642647,CDM,J2312,HCPCS,Facility,both,,,,15.25,7.63,,,,,,,,,,,,
"HEPARIN 25,000UNITS /D5W 500ML",5642651,CDM,J2309,HCPCS,Facility,both,,,,88.56,44.28,,,,,,,,,,,,
HYDROXYCHLOROQUINE TB 200MG,5642676,CDM,J2333,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
hydrOXYzine HCL TAB 10MG,5642681,CDM,J2336,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
Hyperrab 300 UNIT/ML VIAL,5642688,CDM,J2340,HCPCS,Facility,both,,,,1670.5,835.25,,,,,,,,,,,,
Norepinephrine Bit 1 MG,5642773,CDM, J7668,HCPCS,Facility,inpatient,,,,58.24,29.12,,,,,,,,,,,,
LEVOTHYROXINE TAB 137MCG NF,5642776,CDM,J8499,HCPCS,Facility,outpatient,,,,4.5,2.25,,,,,,,,,,,,
Lithium Carbonate Caps 150mg,5642777,CDM,J8499,HCPCS,Facility,outpatient,,,,12,6,,,,,,,,,,,,
Loratadine – D 24 Hr. 10/240,5642778,CDM,J8499,HCPCS,Facility,outpatient,,,,25.75,12.88,,,,,,,,,,,,
LIDOCAINE 4% TOP CREAM 5 GM,5642800,CDM,J2001,HCPCS,Facility,both,,,,44.5,22.25,,,,,,,,,,,,
ATORVASTATIN TAB 40MG,5642808,CDM,1022,HCPCS,Facility,outpatient,,,,7.5,3.75,,,,,,,,,,,,
NITROGLYCER 50MG/D5W 250ML PM,5643015,CDM, J1190,HCPCS,Facility,inpatient,,,,112.74,56.37,,,,,,,,,,,,
NITROGLYCERIN  SL TAB : 0.4MG,5643019,CDM, J2001,HCPCS,Facility,outpatient,,,,6.75,3.38,,,,,,,,,,,,
INSULIN HUMULIN N ONE UNIT EA,5643030,CDM,J2352,HCPCS,Facility,both,,,,15,7.5,,,,,,,,,,,,
Pantoprazole Sodium 40 MG VIAL,5643187,CDM, J8499,HCPCS,Facility,outpatient,,,,35,17.5,,,,,,,,,,,,
flumazenil INJ 0.5MG/5ML MDV,5643233,CDM,J2263,HCPCS,Facility,both,,,,47.5,23.75,,,,,,,,,,,,
KETOROLAC INJ 15MG/ML,5643388,CDM,J1885,HCPCS,Facility,both,,,,15,7.5,,,,,,,,,,,,
FENOFIBRATE TAB 48MG,5643418,CDM,J2242,HCPCS,Facility,outpatient,,,,5,2.5,,,,,,,,,,,,
ASCORBIC ACID TAB 500MG,5643493,CDM,1018,HCPCS,Facility,outpatient,,,,3.25,1.63,,,,,,,,,,,,
CARVEDILOL  TAB 3.125MG,5643603,CDM,J1320,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
dilTIAZem 125MG/25ML INJ VIAL,5643634,CDM,J2120,HCPCS,Facility,both,,,,68.25,34.13,,,,,,,,,,,,
GLIMEPIRIDE TAB 2MG,5643655,CDM,J2285,HCPCS,Facility,outpatient,,,,4.5,2.25,,,,,,,,,,,,
MEROPENEM INJ 1 GM,5643682,CDM, J0770,HCPCS,Facility,both,,,,300,150,,,,,,,,,,,,
MORPHINE SUL INJ 4MG/ML,5643693,CDM, J2270,HCPCS,Facility,both,,,,25.83,12.92,,,,,,,,,,,,
ACTIVATED CHARC-SORB 50G/240ML,5643761,CDM,A4206,HCPCS,Facility,outpatient,,,,100.25,50.13,,,,,,,,,,,,
ALENDRONATE TAB 10MG,5643766,CDM,J8499,HCPCS,Facility,outpatient,,,,18,9,,,,,,,,,,,,
Chewable Aspirin 81mg,5643784,CDM,J1480,HCPCS,Facility,outpatient,,,,7.7,3.85,,,,,,,,,,,,
BUMETANIDE TAB 0.5MG,5643806,CDM,J1180,HCPCS,Facility,outpatient,,,,65.25,32.63,,,,,,,,,,,,
CARVEDILOL TAB 12.5MG,5643822,CDM,J1330,HCPCS,Facility,outpatient,,,,6,3,,,,,,,,,,,,
CARVEDILOL TAB 25MG,5643823,CDM,J1340,HCPCS,Facility,outpatient,,,,8,4,,,,,,,,,,,,
CARVEDILOL TAB 6.25MG,5643824,CDM,J1350,HCPCS,Facility,outpatient,,,,1.5,0.75,,,,,,,,,,,,
DICLOFENAC POT  TAB  50MG,5643861,CDM,J2050,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
ENTACAPONE  TAB 200MG,5643880,CDM,J2215,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
ERTAPENEM 500MG / NS 100ML,5643884,CDM,J2224,HCPCS,Facility,both,,,,104.3,52.15,,,,,,,,,,,,
FENOFIBRATE CAP 160MG,5643893,CDM,J2241,HCPCS,Facility,outpatient,,,,10.5,5.25,,,,,,,,,,,,
GLYCOPYRROLATE INJ 0.2MG/1ML,5643918,CDM,J2297,HCPCS,Facility,both,,,,10,5,,,,,,,,,,,,
LITHIUM CARBONATE ER TAB 450MG,5643980,CDM,J8499,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
PROTAMINE INJ 50MG/5ML SDV,5644070,CDM, J1245,HCPCS,Facility, inpatient,,,,37.5,18.75,,,,,,,,,,,,
LEVOTHYROXINE TAB 88 MCG,5644101,CDM,J8499,HCPCS,Facility,outpatient,,,,4,2,,,,,,,,,,,,
0.45% Sodium Chloride,5644172,CDM,J7030,HCPCS,Facility,outpatient,,,,60,30,,,,,,,,,,,,
Dextrose 5%-0.9% Nacl IV Soln,5644180,CDM,J1960,HCPCS,Facility,both,,,,60,30,,,,,,,,,,,,
CLINDAMYCIN  INJ 600MG/4ML,5644201,CDM,J1600,HCPCS,Facility,outpatient,,,,71.22,35.61,,,,,,,,,,,,
LEVOTHYROXINE TAB 75 MCG,5644438,CDM,J8499,HCPCS,Facility,outpatient,,,,4,2,,,,,,,,,,,,
ALPRAZolam TAB 0.5MG,5644455,CDM,J8499,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
CHOLECALCIFEROL TB 1000 IU,5644495,CDM,J1550,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
"EPOETIN NON-ESRD INJ20,000U/ML",5644498,CDM,J2221,HCPCS,Facility,both,,,,1069,534.5,,,,,,,,,,,,
ERTAPENEM 1GM / NS 100ML,5644521,CDM,J2223,HCPCS,Facility,both,,,,208.6,104.3,,,,,,,,,,,,
FEXOFENADINE TAB 180MG,5644523,CDM,J2254,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
LISINOPRIL TAB 40MG,5644528,CDM,J8499,HCPCS,Facility,outpatient,,,,7.5,3.75,,,,,,,,,,,,
CLINDAMYCIN  600MG / NS 100ML,5644533,CDM,J1590,HCPCS,Facility,outpatient,,,,15,7.5,,,,,,,,,,,,
DOXYcycline 100MG / NS 250ML,5644534,CDM,J2370,HCPCS,Facility,both,,,,94.06,47.03,,,,,,,,,,,,
LEVOTHYROXINE TAB 125 MCG,5644540,CDM,J8499,HCPCS,Facility,outpatient,,,,4.5,2.25,,,,,,,,,,,,
LEVOTHYROXINE TAB  50 MCG,5644541,CDM,J8499,HCPCS,Facility,outpatient,,,,4,2,,,,,,,,,,,,
CEFEPIME 2GM / NS 100ML,5644553,CDM,J1390,HCPCS,Facility,outpatient,,,,35.58,17.79,,,,,,,,,,,,
HumuLIN R 100 UNITS /100 ML NS,5644555,CDM,J2316,HCPCS,Facility,both,,,,11.5,5.75,,,,,,,,,,,,
FINGER STICK BLOOD GLUCOSE,5644558,CDM,J2256,HCPCS,Facility,both,,,,10,5,,,,,,,,,,,,
GLUCERNA 1.2CAL 240ML,5644574,CDM,J2290,HCPCS,Facility,outpatient,,,,23.5,11.75,,,,,,,,,,,,
DAKIN'S SOL 0.25%  480ML,5644582,CDM,J2190,HCPCS,Facility,outpatient,,,,83.75,41.88,,,,,,,,,,,,
ACYCLOVIR 1000MG/NS 250ML,5644617,CDM,J0696,HCPCS,Facility,outpatient,,,,134,67,,,,,,,,,,,,
ACYCLOVIR 500MG/NS 100ML,5644648,CDM,J0696,HCPCS,Facility,outpatient,,,,67.5,33.75,,,,,,,,,,,,
PANTOPRAZOLE 80MG/100ML DRIP,5644668,CDM, J8499,HCPCS,Facility,outpatient,,,,35,17.5,,,,,,,,,,,,
FEBUXOSTAT TAB 40MG,5644690,CDM,J2238,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
VANCO 25MG/ML ORALSOL150ML,5644720,CDM, J8499,HCPCS,Facility,outpatient,,,,35,17.5,,,,,,,,,,,,
LANSOPRAZOLE 3MG/ML SUS 90ML,5644732,CDM,J8499,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
LORAZEPAM INTENS 2MG/ML  10ml vial,5644749,CDM,J2060,HCPCS,Facility,both,,,,60,30,,,,,,,,,,,,
DAPTOMYCIN 500MG / NS 100ML,5644767,CDM,J1690,HCPCS,Facility,both,,,,25,12.5,,,,,,,,,,,,
FLUTICASONE DISKUS INH 50MCG,5644782,CDM,J2271,HCPCS,Facility,both,,,,41.5,20.75,,,,,,,,,,,,
niCARdipine INJ 25MG/10ML SDV,5644783,CDM, J3300,HCPCS,Facility,inpatient,,,,153.12,76.56,,,,,,,,,,,,
Insulin DeteMIR  PER UNIT,5644828,CDM,J2348,HCPCS,Facility,both,,,,37.5,18.75,,,,,,,,,,,,
GLUCERNA 1.5CAL 240ML,5644902,CDM,J2291,HCPCS,Facility,outpatient,,,,23.5,11.75,,,,,,,,,,,,
HYDROCORTISONE 1% CRM 26 GM,5644904,CDM,J2327,HCPCS,Facility,outpatient,,,,56.75,28.38,,,,,,,,,,,,
FENOFIBRIC ACID  CAP 45MG,5644905,CDM,J2243,HCPCS,Facility,outpatient,,,,5.25,2.63,,,,,,,,,,,,
BIMATOPROST 0.01% OP SOLN,5644908,CDM,J1100,HCPCS,Facility,outpatient,,,,44,22,,,,,,,,,,,,
LevETIRAcetam INJ 500MG/5ML,5644967,CDM,J8499,HCPCS,Facility,both,,,,250,125,,,,,,,,,,,,
LevETIRAcetam 500MG/ NS 100ML,5644968,CDM,J8499,HCPCS,Facility,both,,,,250,125,,,,,,,,,,,,
PHYTONADIONE INJ 1MG/0.5ML,5645015,CDM,J1810,HCPCS,Facility,outpatient,,,,256.75,128.38,,,,,,,,,,,,
CHOLECALCIFEROL Cp 2000 IU,5645029,CDM,J1540,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
ROCURONIUM  50 MG/5 ML,5645060,CDM,J1170,HCPCS,Facility,inpatient,,,,45.5,22.75,,,,,,,,,,,,
DABIGATRAN ETEXILATE CAP 150MG,5645256,CDM,J1890,HCPCS,Facility,outpatient,,,,6,3,,,,,,,,,,,,
FAT EMULSION 20% IV BAG 250ML,5645260,CDM,J2237,HCPCS,Facility,both,,,,92.5,46.25,,,,,,,,,,,,
KETOCONAZOLE 2% SHAMP 120ML,5645315,CDM,J3490,HCPCS,Facility,outpatient,,,,58,29,,,,,,,,,,,,
LisinopriL 5 MG TAB,5645337,CDM,J8499,HCPCS,Facility,outpatient,,,,7.5,3.75,,,,,,,,,,,,
HumuLIN R 3ML VL 100 UNITS/ML,5645354,CDM,J2317,HCPCS,Facility,both,,,,11.5,5.75,,,,,,,,,,,,
FESOTERODINE 8MG TAB,5645379,CDM,J2253,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
PIPERACN/TAZOBACTAM INJ 4.5GM,5645393,CDM, J8499,HCPCS,Facility,outpatient,,,,51.38,25.69,,,,,,,,,,,,
ACETYLCYSTEINE INH 20%SOL 10ML,5645404,CDM,J8499,HCPCS,Facility,outpatient,,,,1.25,0.63,,,,,,,,,,,,
LINAGLIPTIN TAB 5MG,5645410,CDM,J8499,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
DOUBLE ANTIB OINT PKT 0.9GM UD,5645412,CDM,J2320,HCPCS,Facility,both,,,,5,2.5,,,,,,,,,,,,
BRIMONIDINE/BRINZOL OP SUSP8ML,5645420,CDM,J1130,HCPCS,Facility,outpatient,,,,196,98,,,,,,,,,,,,
EUCERIN HEALING CREAM 4OZ,5645432,CDM,J2230,HCPCS,Facility,outpatient,,,,38,19,,,,,,,,,,,,
DAPTOmycin INJ 500MG,5645448,CDM,J1700,HCPCS,Facility,both,,,,20,10,,,,,,,,,,,,
INSULIN 70/30 (HUMULIN 70/30),5645456,CDM,J2347,HCPCS,Facility,both,,,,15.25,7.63,,,,,,,,,,,,
HumuLIN 70/30 3ML 100UNIT/ML,5645457,CDM,J2315,HCPCS,Facility,both,,,,11.5,5.75,,,,,,,,,,,,
DARIFENACIN TAB 7.5MG,5645458,CDM,J1750,HCPCS,Facility,outpatient,,,,3,1.5,,,,,,,,,,,,
HYDROmorphone INJ 1MG/ML,5645490,CDM,J2329,HCPCS,Facility,both,,,,15.25,7.63,,,,,,,,,,,,
AMOXICILLIN TAB 875MG,5645495,CDM,J8499,HCPCS,Facility,outpatient,,,,7.3,3.65,,,,,,,,,,,,
CEFEPIME 1GM / NS 100ML,5645505,CDM,J1380,HCPCS,Facility,outpatient,,,,17.79,8.9,,,,,,,,,,,,
Co Q-10 CAP 50MG,5645517,CDM,J1680,HCPCS,Facility,outpatient,,,,12,6,,,,,,,,,,,,
LIDOCAINE 2% GLYDO JELLY 11ML,5645550,CDM,J2001,HCPCS,Facility,both,,,,44.5,22.25,,,,,,,,,,,,
AZITHROMYCIN INJ 500MG,5691008,CDM,J1060,HCPCS,Facility,outpatient,,,,35.25,17.63,,,,,,,,,,,,
Dextrose 5%-0.45% Nacl IV Soln,5691016,CDM,J1950,HCPCS,Facility,both,,,,60,30,,,,,,,,,,,,
D5 1/2 NS + 40MEQ KCL 1000ML,5691017,CDM,J1820,HCPCS,Facility,outpatient,,,,63.5,31.75,,,,,,,,,,,,
D5 1/2 NS + 20MEQ KCL 1000ML,5691021,CDM,J1810,HCPCS,Facility,outpatient,,,,60.75,30.38,,,,,,,,,,,,
Dextrose 5%-LR IV Solution,5691022,CDM,J1970,HCPCS,Facility,both,,,,60,30,,,,,,,,,,,,
Dextrose 5%-Water IV Soln,5691028,CDM,J1980,HCPCS,Facility,both,,,,60,30,,,,,,,,,,,,
D5W 100ML,5691029,CDM,J1850,HCPCS,Facility,outpatient,,,,15,7.5,,,,,,,,,,,,
Dextrose 5% w/ 20 Meq KCL,5691030,CDM,J1930,HCPCS,Facility,both,,,,43.15,21.58,,,,,,,,,,,,
Dextrose 5%-Water IV Soln (Exc,5691031,CDM,J1990,HCPCS,Facility,both,,,,60,30,,,,,,,,,,,,
D5W 500ML,5691032,CDM,J1870,HCPCS,Facility,outpatient,,,,30,15,,,,,,,,,,,,
D5W WITH KCL 20MEQ 1000ML,5691034,CDM,J1880,HCPCS,Facility,outpatient,,,,60,30,,,,,,,,,,,,
D5NS + 20MEQ KCL 1000ML,5691038,CDM,J1830,HCPCS,Facility,outpatient,,,,60,30,,,,,,,,,,,,
LevoFLOXacin 500 MG/100 ML-D5W,5691053,CDM,J7611,HCPCS,Facility,both,,,,35,17.5,,,,,,,,,,,,
LR 1000ML,5691057,CDM,S5001,HCPCS,Facility,both,,,,60,30,,,,,,,,,,,,
0.9 % Sodium Chloride,5691064,CDM,J7030,HCPCS,Facility,outpatient,,,,60,30,,,,,,,,,,,,
LUBIPROSTONE CAP 24 MCG,5695033,CDM,J8499,HCPCS,Facility,outpatient,,,,3.34,1.67,,,,,,,,,,,,
LEVOTHYROXINE INJ 100 MCG,5695141,CDM,J8499,HCPCS,Facility,both,,,,4.75,2.38,,,,,,,,,,,,
SOD CHLOR IRRIGAT Soln0.9% 3L,5695143,CDM, J1399,HCPCS,Facility,outpatient,,,,60,30,,,,,,,,,,,,
Bamlanivimab (EUA),5695149,CDM,J1080,HCPCS,Facility,outpatient,,,,15,7.5,,,,,,,,,,,,
"Hepain 25,000 UNIT/500-1/2 NS",5695157,CDM,J2308,HCPCS,Facility,both,,,,88.56,44.28,,,,,,,,,,,,
Amoxicilin 400 MG/5 ML,5695158,CDM,J8499,HCPCS,Facility,outpatient,,,,4.15,2.08,,,,,,,,,,,,
hydrOXYzine HCL,5695159,CDM,J2335,HCPCS,Facility,both,,,,127.25,63.63,,,,,,,,,,,,
Domeboro Powder Packet,5695161,CDM,J2280,HCPCS,Facility,outpatient,,,,5.5,2.75,,,,,,,,,,,,
SOLU-MedroL,5695164,CDM, J2920,HCPCS,Facility,outpatient,,,,68.25,34.13,,,,,,,,,,,,
diazePAM Rectal Syringe,5695167,CDM,J2020,HCPCS,Facility,both,,,,1213.75,606.88,,,,,,,,,,,,
Procrit,5695168,CDM, J0881,HCPCS,Facility,outpatient,,,,40,20,,,,,,,,,,,,
Ketalar,5695175,CDM,J2001,HCPCS,Facility,both,,,,3,1.5,,,,,,,,,,,,
fentaNYL 250 MCG/5 ML VIAL,5695176,CDM,J2247,HCPCS,Facility,both,,,,15,7.5,,,,,,,,,,,,
Fentanyl 12mcG patch,5695177,CDM,J2246,HCPCS,Facility,both,,,,97.5,48.75,,,,,,,,,,,,
Oxytocin,5695178,CDM, J1720,HCPCS,Facility,inpatient,,,,62.5,31.25,,,,,,,,,,,,
MODERNA COVID-19 VACCINE (EUA) 1st Dose,5695179,CDM,91301,HCPCS,Facility,both,,,,25,12.5,,,,,,,,,,,,
MODERNA COVID-19 VACCINE (EUA) 2nd Dose,5695180,CDM,91301,HCPCS,Facility,both,,,,25,12.5,,,,,,,,,,,,
MODERNA COVID-19 VACCINE (EUA) 3rd Dose,5695181,CDM,91301,HCPCS,Facility,both,,,,25,12.5,,,,,,,,,,,,
MODERNA COVID-19 VACCINE (EUA) Booster,5695182,CDM,91301,HCPCS,Facility,both,,,,25,12.5,,,,,,,,,,,,
Cyclopentolate 1%,5695185,CDM,J1800,HCPCS,Facility,outpatient,,,,42,21,,,,,,,,,,,,
GuaiFENesin/Dextro 1 EA,5695187,CDM,J2302,HCPCS,Facility,outpatient,,,,5,2.5,,,,,,,,,,,,
Buprenorphin-Naloxon 8-2 MG SL,5695189,CDM,J1200,HCPCS,Facility,outpatient,,,,16.75,8.38,,,,,,,,,,,,
Fleet Enema,5695191,CDM,J2258,HCPCS,Facility,both,,,,3,1.5,,,,,,,,,,,,
Etesevimab (EUA),5695198,CDM,J2228,HCPCS,Facility,both,,,,15,7.5,,,,,,,,,,,,
TRANS RTN WORKUP,5701041,CDM,86078,CPT,Facility,both,,,,205,102.5,,,,,,,,,,,,
FFP PER UNIT,5701043,CDM,P9017,HCPCS,Facility,both,,,,105,52.5,,,,,,,,,,,,
LEUKOREDUCED RBC UNIT,5701047,CDM,P9016,HCPCS,Facility,both,,,,470,235,,,,,,,,,,,,
AVUL NAIL PLATE SINGLE SIMPLE,6000001,CDM,11730,CPT,Facility,outpatient,,,,215,107.5,,,,,,,,,,,,
DRESS/DEB PARTIAL BURNS 5-10%,6000004,CDM,16025,CPT,Facility,outpatient,,,,505,252.5,,,,,,,,,,,,
CARDIOVERSION ELECTIVE EXT,6000005,CDM,92960,CPT,Facility,both,,,,1721.19,860.6,,,,,,,,,,,,
CPR,6000006,CDM,92950,CPT,Facility,both,,,,810.87,405.44,,,,,,,,,,,,
DRAIN ABSCE EXT EAR CAN SIMP,6000008,CDM,69000,CPT,Facility,both,,,,458,229,,,,,,,,,,,,
ER - LEVEL 1,6000009,CDM,99281,CPT,Facility,both,,,,222.24,111.12,,,,,,,,,,,,
ER- CRIT CARE 1ST 30-74 MIN,6000014,CDM,99291,CPT,Facility,both,,,,2282.22,1141.11,,,,,,,,,,,,
FB REMOVAL EYE CONJUCT,6000018,CDM,65205,CPT,Facility,both,,,,345.48,172.74,,,,,,,,,,,,
FB REMOVAL UPPER ARM SQ,6000020,CDM,24200,CPT,Facility,inpatient,,,,1543,771.5,,,,,,,,,,,,
FB REMOVAL EXT AUDITORY CANAL,6000023,CDM,69200,CPT,Facility,both,,,,322,161,,,,,,,,,,,,
THER/PROPH/DX INJECT IM/SQ,6000032,CDM,96372,CPT,Facility,both,,,,189.96,94.98,,,,,,,,,,,,
IV HYDRATION 31MIN TO 1HR,6000034,CDM,96360,CPT,Facility,both,,,,626.79,313.4,,,,,,,,,,,,
IV HYDRATION EA ADD HR,6000035,CDM,96361,CPT,Facility,both,,,,293,146.5,,,,,,,,,,,,
IV INFUSION THERAPY INITIAL HR,6000039,CDM,96365,CPT,Facility,both,,,,508,254,,,,,,,,,,,,
IV PUSH EACH ADD SEQ NEW DRUG,6000040,CDM,96375,CPT,Facility,both,,,,235,117.5,,,,,,,,,,,,
REM IMPACT CERUMEN W/INST UNI,6000045,CDM,69210,CPT,Facility,both,,,,43,21.5,,,,,,,,,,,,
LAC INTER NEC <=2.5CM,6000046,CDM,12041,CPT,Facility,outpatient,,,,508,254,,,,,,,,,,,,
LAC INT NECK/HAND/FT 7.6-12.5,6000047,CDM,12044,CPT,Facility,outpatient,,,,995,497.5,,,,,,,,,,,,
LAC INT NECK/HAND/FT 2.6-7.5,6000048,CDM,12042,CPT,Facility,outpatient,,,,604,302,,,,,,,,,,,,
LAC INT NECK/HAND/FT 12.6-20.0,6000049,CDM,12045,CPT,Facility,outpatient,,,,1244,622,,,,,,,,,,,,
LAC INTER FACE/EAR/LIP <=2.5,6000050,CDM,12051,CPT,Facility,outpatient,,,,600,300,,,,,,,,,,,,
LAC RPR INT/TK/EXT 12.5-20.0CM,6000052,CDM,12035,CPT,Facility,outpatient,,,,1173,586.5,,,,,,,,,,,,
LAC SIMPLE FACE/EAR/LIP 2.6-5,6000059,CDM,12013,CPT,Facility,outpatient,,,,527,263.5,,,,,,,,,,,,
LAC SIMPLE FACE/EAR/LIP 5.1-7,6000060,CDM,12014,CPT,Facility,outpatient,,,,459,229.5,,,,,,,,,,,,
LAC SIMPLE FAC 7.6-12.5,6000061,CDM,12015,CPT,Facility,outpatient,,,,923,461.5,,,,,,,,,,,,
LAC SIMPLE SCALP/TRNK<=2.5CM,6000062,CDM,12001,CPT,Facility,outpatient,,,,403,201.5,,,,,,,,,,,,
LAC SIMPLE SCALP/TRNK 12.6-20,6000063,CDM,12005,CPT,Facility,outpatient,,,,818,409,,,,,,,,,,,,
LAC SIMPLE SCALP/TRNK 2.6-7.5,6000064,CDM,12002,CPT,Facility,outpatient,,,,493,246.5,,,,,,,,,,,,
LAC SIMPLE SCALP/TRNK 7.6-12.5,6000066,CDM,12004,CPT,Facility,outpatient,,,,605,302.5,,,,,,,,,,,,
TX SUP WOUND DEHISCENCE SIMP,6000072,CDM,12020,CPT,Facility,outpatient,,,,1070,535,,,,,,,,,,,,
CLD TX OF SHLDR W/MA,6000073,CDM,23650,CPT,Facility,inpatient,,,,1564,782,,,,,,,,,,,,
BLOOD ADMINISTRATION 0-4 HRS,6000080,CDM,36430,CPT,Facility,both,,,,111,55.5,,,,,,,,,,,,
BLOOD ADMINISTRATION >4-8 HRS,6000081,CDM,36430,CPT,Facility,both,,,,111,55.5,,,,,,,,,,,,
ER LEVEL 1 (MSE ONLY),6001006,CDM,99281,CPT,Facility,both,,,,222.24,111.12,,,,,,,,,,,,
ER LEVEL 2 (W/MOD 25),6001007,CDM,99282,CPT,Facility,both,,,,402.45,201.23,,,,,,,,,,,,
ER LEVEL 3 (W/MOD 25),6001008,CDM,99283,CPT,Facility,both,,,,709.05,354.53,,,,,,,,,,,,
ER LEVEL 4 (W/MOD 25),6001009,CDM,99284,CPT,Facility,both,,,,1114.56,557.28,,,,,,,,,,,,
ER LEVEL 5 (W/MOD 25),6001010,CDM,99285,CPT,Facility,both,,,,1599.81,799.91,,,,,,,,,,,,
CRIT CARE <74MIN (W/MOD 25),6001011,CDM,99291,CPT,Facility,both,,,,2282.22,1141.11,,,,,,,,,,,,
TEMP TRANSCUT PACING,6001017,CDM,92953,CPT,Facility,both,,,,1721.19,860.6,,,,,,,,,,,,
THROMBOLYSIS CORONARY IV INF,6001018,CDM,92977,CPT,Facility,both,,,,976.92,488.46,,,,,,,,,,,,
VENIPUNCTURE BY ED STAFF,6001019,CDM,36415,CPT,Facility,both,,,,105,52.5,,,,,,,,,,,,
EKG TRACING ONLY,6001020,CDM,93005,CPT,Facility,both,,,,384.25,192.13,,,,,,,,,,,,
GASTRIC INTUBATION/LAVAGE,6001022,CDM,43753,CPT,Facility,inpatient,,,,326,163,,,,,,,,,,,,
ANTIBIOTIC ADMINISTRATION,6001025,CDM,96372,CPT,Facility,both,,,,189.96,94.98,,,,,,,,,,,,
THER PHLEBOTOMY,6001026,CDM,99195,CPT,Facility,both,,,,201,100.5,,,,,,,,,,,,
IV INJECTION PUSH INITIAL,6001029,CDM,96374,CPT,Facility,both,,,,235,117.5,,,,,,,,,,,,
EMTALA SCREENING (NOT CVD MCR),6001035,CDM,99281,CPT,Facility,both,,,,222.24,111.12,,,,,,,,,,,,
IV INFUSION THERAPY ADDTL HR,6001036,CDM,96366,CPT,Facility,both,,,,181,90.5,,,,,,,,,,,,
SUTURE REMOVAL/RECHECK,6001040,CDM,99211,CPT,Facility,both,,,,40.47,20.24,,,,,,,,,,,,
EXC MALIG LESN  1.1-2.0CM,6001049,CDM,11602,CPT,Facility,outpatient,,,,500,250,,,,,,,,,,,,
IV INF ADD SEQ DRUG UP TO 1 HR,6001060,CDM,96367,CPT,Facility,both,,,,243,121.5,,,,,,,,,,,,
IV Push each additional sequential same drug,6001061,CDM,96376,CPT,Facility, outpatient,,,,187,93.5,,,,,,,,,,,,
APPLY FINGER SPLINT STATIC,6001062,CDM,29130,CPT,Facility,both,,,,173,86.5,,,,,,,,,,,,
APPLY LONG ARM SPLINT,6001063,CDM,29105,CPT,Facility,both,,,,411,205.5,,,,,,,,,,,,
APPLY SHORT LEG SPLINT,6001064,CDM,29515,CPT,Facility,both,,,,351,175.5,,,,,,,,,,,,
APPLY SHORT ARM SPLINT,6001065,CDM,29125,CPT,Facility,both,,,,311,155.5,,,,,,,,,,,,
ASP/INJECT INTE J/O US GUIDE,6001067,CDM,20605,CPT,Facility,both,,,,180,90,,,,,,,,,,,,
CATHETER COLLECT SPEC,6001069,CDM,P9612,HCPCS,Facility,both,,,,12,6,,,,,,,,,,,,
CLSD TX NUR ELBOW W/ MANIP,6001074,CDM,24640,CPT,Facility,inpatient,,,,631.5,315.75,,,,,,,,,,,,
CLSD TX METAC DISL SIN W/MAN,6001076,CDM,26700,CPT,Facility,both,,,,993,496.5,,,,,,,,,,,,
CLOSED TX CLAV FX W/O MANIP,6001077,CDM,23500,CPT,Facility,inpatient,,,,856,428,,,,,,,,,,,,
CLOSED TX OF PAT DISL,6001078,CDM,27560,CPT,Facility,inpatient,,,,2246,1123,,,,,,,,,,,,
CLSD TX TEMROROR DISL,6001079,CDM,21480,CPT,Facility,inpatient,,,,512,256,,,,,,,,,,,,
CLSD TX INTERL JT W/O ANES,6001080,CDM,26770,CPT,Facility,both,,,,1363,681.5,,,,,,,,,,,,
CD TX SER W/MANIP&ANES,6001081,CDM,27415,CPT,Facility, outpatient,,,,4267.53,2133.77,,,,,,,,,,,,
CLD TX OF CARTACARPAL,6001084,CDM,26641,CPT,Facility,both,,,,1232,616,,,,,,,,,,,,
CONT NASAL HEM  INITIAL,6001086,CDM,30905,CPT,Facility,both,,,,304,152,,,,,,,,,,,,
CON NASAL HEM ANTOR C,6001087,CDM,30903,CPT,Facility,both,,,,304,152,,,,,,,,,,,,
COL NASAL HEM ANR SIMPLE,6001088,CDM,30901,CPT,Facility,both,,,,394,197,,,,,,,,,,,,
DEST PRE-MALIG LE 1ST LESN,6001090,CDM,17000,CPT,Facility,outpatient,,,,160,80,,,,,,,,,,,,
IMMUNIZATION ADMINISTRATION,6001093,CDM,90471,CPT,Facility,both,,,,25,12.5,,,,,,,,,,,,
INC THROMBOSED HEMID EXTL,6001095,CDM,46083,CPT,Facility,inpatient,,,,458,229,,,,,,,,,,,,
I&D BARTHOLIN CYST,6001096,CDM,56420,CPT,Facility,both,,,,521.97,260.99,,,,,,,,,,,,
I&D DEEP ABSCESS,6001097,CDM,21501,CPT,Facility,inpatient,,,,1722,861,,,,,,,,,,,,
I&D ISCHIO/PERIRECTAL ABS,6001098,CDM,46040,CPT,Facility,inpatient,,,,1260,630,,,,,,,,,,,,
"I&D ABSCESS SIMPLE, SNGL",6001099,CDM,10060,CPT,Facility,outpatient,,,,550.2,275.1,,,,,,,,,,,,
I&D ABSCESS COMPL/MULTI,6001100,CDM,10061,CPT,Facility,outpatient,,,,967,483.5,,,,,,,,,,,,
FB REMO SIMPLE W/INCISION,6001102,CDM,10120,CPT,Facility,outpatient,,,,1765,882.5,,,,,,,,,,,,
INITIAL TX 1ST DEGREE BURN,6001103,CDM,16000,CPT,Facility,outpatient,,,,270,135,,,,,,,,,,,,
DRS/DBRDMT PRTL 1ST DEGREE BURN,6001104,CDM,16030,CPT,Facility,outpatient,,,,550.2,275.1,,,,,,,,,,,,
ASP/INJECT MAJO W/O US GUIDE,6001105,CDM,20610,CPT,Facility,both,,,,892,446,,,,,,,,,,,,
TUBE THOCONNECT TO DRAIN,6001106,CDM,32551,CPT,Facility,inpatient,,,,304,152,,,,,,,,,,,,
TEMP INDWEL CATH SIMPLE,6001107,CDM,51702,CPT,Facility,both,,,,379,189.5,,,,,,,,,,,,
NON-TUNNEL CENTRAL CATH 5>,6001108,CDM,36556,CPT,Facility,both,,,,111,55.5,,,,,,,,,,,,
NON-INDWELLING CATH,6001109,CDM,51701,CPT,Facility,both,,,,262,131,,,,,,,,,,,,
IRRIGATE IMPLD VES ACCESS,6001112,CDM,96523,CPT,Facility,both,,,,218,109,,,,,,,,,,,,
LAC COMP  2.6-7.5,6001113,CDM,13132,CPT,Facility,outpatient,,,,1148,574,,,,,,,,,,,,
LAC COMPLEX 1.1-2.5CM,6001115,CDM,13131,CPT,Facility,outpatient,,,,1080,540,,,,,,,,,,,,
FB REMOVAL EXT EYE EMBEDDED,6001133,CDM,65210,CPT,Facility,both,,,,406,203,,,,,,,,,,,,
FB REMOVAL EMBE FB MOUTH,6001139,CDM,40804,CPT,Facility,both,,,,914,457,,,,,,,,,,,,
STRAPPING ANKLE AND OR FOOT,6001141,CDM,29540,CPT,Facility,both,,,,173,86.5,,,,,,,,,,,,
STRAPPING TOES,6001142,CDM,29550,CPT,Facility,both,,,,99,49.5,,,,,,,,,,,,
STRAPPING HAND OR FINGER,6001143,CDM,29280,CPT,Facility,both,,,,239,119.5,,,,,,,,,,,,
STRAPPING ELBOW OR WRIST,6001144,CDM,29260,CPT,Facility,both,,,,54,27,,,,,,,,,,,,
STRAPPING SHOULDER,6001145,CDM,29240,CPT,Facility,both,,,,173,86.5,,,,,,,,,,,,
STRAPPING KNEE,6001146,CDM,29530,CPT,Facility,both,,,,173,86.5,,,,,,,,,,,,
STRAPPING THORAX,6001147,CDM,29200,CPT,Facility,both,,,,173,86.5,,,,,,,,,,,,
CLOSED TX EL DISLOC W/O ANES,6001152,CDM,24600,CPT,Facility,inpatient,,,,4043,2021.5,,,,,,,,,,,,
EXPLORE WOUND EXTREMITY,6001153,CDM,20103,CPT,Facility,inpatient,,,,2373,1186.5,,,,,,,,,,,,
DEBRID SKIN/SQ TISSUE 1ST 20CM,6001171,CDM,11042,CPT,Facility,outpatient,,,,1837,918.5,,,,,,,,,,,,
DEBRID SKIN/SQ MUSCLE 1ST 20CM,6001172,CDM,11043,CPT,Facility,outpatient,,,,741,370.5,,,,,,,,,,,,
EXCISION NAIL AND NAIL MATRIX,6001174,CDM,11750,CPT,Facility,outpatient,,,,642,321,,,,,,,,,,,,
NAIL BED REPAIR SIMPLE,6001175,CDM,11760,CPT,Facility,outpatient,,,,1003,501.5,,,,,,,,,,,,
LAC INTER FACE 12.6-20.0 CM,6001179,CDM,12055,CPT,Facility,outpatient,,,,1530,765,,,,,,,,,,,,
LAC COMPLEX  1.1-2.5CM,6001182,CDM,13120,CPT,Facility,outpatient,,,,844,422,,,,,,,,,,,,
LAC COMPLEX  2.6-7.5CM,6001183,CDM,13121,CPT,Facility,outpatient,,,,1028,514,,,,,,,,,,,,
INJ TRIGER POINT 1 OR 2 MUSCLE,6001186,CDM,20552,CPT,Facility,both,,,,180,90,,,,,,,,,,,,
TX MANDFX W/O MANIP,6001188,CDM,21450,CPT,Facility,inpatient,,,,2942,1471,,,,,,,,,,,,
TX VERT BODY FX W/O MAN,6001191,CDM,22310,CPT,Facility,inpatient,,,,1344,672,,,,,,,,,,,,
TX AC JOINT W/O MANIP,6001192,CDM,23540,CPT,Facility,inpatient,,,,1563,781.5,,,,,,,,,,,,
TX SCAR FX W/O MANIP,6001193,CDM,23570,CPT,Facility,inpatient,,,,859,429.5,,,,,,,,,,,,
TX PROX HUMERA,6001194,CDM,23600,CPT,Facility,inpatient,,,,790,395,,,,,,,,,,,,
CD TX HUFX W/O MANIP,6001195,CDM,24500,CPT,Facility,inpatient,,,,1273,636.5,,,,,,,,,,,,
TX HUMERAL FX W/O MANIP,6001196,CDM,24530,CPT,Facility,inpatient,,,,950,475,,,,,,,,,,,,
TX HUMERAL FX W/MANIP,6001197,CDM,24535,CPT,Facility,inpatient,,,,2411,1205.5,,,,,,,,,,,,
TX RADIAL HEAD/NECK W/O MANIP,6001198,CDM,24650,CPT,Facility,inpatient,,,,604,302,,,,,,,,,,,,
TX RADIAL SHFT FX W/O MANIP,6001199,CDM,25500,CPT,Facility,both,,,,938,469,,,,,,,,,,,,
TX ULNAR SHAFT FX W/O MANIP,6001200,CDM,25530,CPT,Facility,both,,,,564,282,,,,,,,,,,,,
RADIAL/ULNAR FX W/O MANIP,6001201,CDM,25560,CPT,Facility,both,,,,1014,507,,,,,,,,,,,,
TX COLLES FX W/O MAN,6001202,CDM,25600,CPT,Facility,both,,,,669,334.5,,,,,,,,,,,,
TX CARPAL SCAPD FX W/O MANIP,6001203,CDM,25622,CPT,Facility,both,,,,1116,558,,,,,,,,,,,,
TX CARPAL BONE FX W/O MANIP,6001204,CDM,25630,CPT,Facility,both,,,,1089,544.5,,,,,,,,,,,,
TX METACARPAL FX W/O MANIP,6001208,CDM,26600,CPT,Facility,both,,,,630,315,,,,,,,,,,,,
TX METACARPAL FX W/ MANIP,6001209,CDM,26605,CPT,Facility,both,,,,1196,598,,,,,,,,,,,,
TX PROXIMAL FINR W/O MANIP,6001210,CDM,26720,CPT,Facility,both,,,,1363,681.5,,,,,,,,,,,,
TX PROXIMAL FINR W/MANIP,6001211,CDM,26725,CPT,Facility,both,,,,1203,601.5,,,,,,,,,,,,
TX POST HIP ARSTY DISL,6001214,CDM,27265,CPT,Facility,inpatient,,,,1690,845,,,,,,,,,,,,
PATELLAR FX,6001215,CDM,27520,CPT,Facility,inpatient,,,,1163,581.5,,,,,,,,,,,,
TX MEDIAL MALL FX W/O MANIP,6001216,CDM,27760,CPT,Facility,inpatient,,,,1154,577,,,,,,,,,,,,
TX PROX FIBULA/S FX W/O MANIP,6001217,CDM,27780,CPT,Facility,inpatient,,,,636,318,,,,,,,,,,,,
TX DISTAL FIB FX W/O MANIP,6001218,CDM,27786,CPT,Facility,inpatient,,,,800,400,,,,,,,,,,,,
TX BIMAR ANKLE FX W/O MAN,6001219,CDM,27808,CPT,Facility,inpatient,,,,1234,617,,,,,,,,,,,,
TX TRIAR ANKLE FX W/O MAN,6001220,CDM,27816,CPT,Facility,inpatient,,,,1205,602.5,,,,,,,,,,,,
TX CALCANEAL FX W/O MANIP,6001221,CDM,28400,CPT,Facility,both,,,,953,476.5,,,,,,,,,,,,
TX TALUS FX W/O MANIP,6001222,CDM,28430,CPT,Facility,both,,,,666,333,,,,,,,,,,,,
TX TARSAL BONE FX W/O MANIP EA,6001223,CDM,28450,CPT,Facility,both,,,,797,398.5,,,,,,,,,,,,
CLOSED TX ML FX W/O MANIP EA,6001224,CDM,28715,CPT,Facility,outpatient,,,,631.5,315.75,,,,,,,,,,,,
CLSD TX TOE FX W/O MANIP,6001225,CDM,28490,CPT,Facility,both,,,,467,233.5,,,,,,,,,,,,
GREAT TOE FX W/ MAN,6001226,CDM,28495,CPT,Facility,both,,,,576,288,,,,,,,,,,,,
CLSD TX TOES 2-5 W/O MANIP EA,6001227,CDM,28510,CPT,Facility,both,,,,583,291.5,,,,,,,,,,,,
CLSD TX TOES 2-5 W/MANIP EA,6001228,CDM,28515,CPT,Facility,both,,,,1623,811.5,,,,,,,,,,,,
METATARSAL DISLOCATION,6001229,CDM,28630,CPT,Facility,both,,,,522,261,,,,,,,,,,,,
VENIPUNCTURE CUTDOWN <1YR,6001234,CDM,36420,CPT,Facility,both,,,,105,52.5,,,,,,,,,,,,
VENOUS IMPLANT COLLECTION,6001238,CDM,36591,CPT,Facility,both,,,,143,71.5,,,,,,,,,,,,
PLACE NEEDLE INTRS INFUSION,6001239,CDM,36680,CPT,Facility,both,,,,138,69,,,,,,,,,,,,
I&D VULVA/PERINEAL ABSCESS,6001242,CDM,56405,CPT,Facility,both,,,,365,182.5,,,,,,,,,,,,
VAGINAL DELIVERY,6001244,CDM,59409,CPT,Facility,both,,,,2793,1396.5,,,,,,,,,,,,
LUMBAR SPINAL PUNCTURE,6001246,CDM,62270,CPT,Facility,outpatient,,,,1945.56,972.78,,,,,,,,,,,,
TRIGEMINAL NERVE BLOCK,6001247,CDM,64400,CPT,Facility,both,,,,600,300,,,,,,,,,,,,
FB REMOVAL EYE CORN W/LAMP,6001249,CDM,65222,CPT,Facility,both,,,,288,144,,,,,,,,,,,,
OMT 1-2 AREAS,6001254,CDM,98925,CPT,Facility,both,,,,81.72,40.86,,,,,,,,,,,,
OMT 3-4 AREAS,6001255,CDM,98926,CPT,Facility,both,,,,81.72,40.86,,,,,,,,,,,,
"I&D PILONIDAL CYST, SIMPLE",6001259,CDM,10080,CPT,Facility,outpatient,,,,624,312,,,,,,,,,,,,
I&D PILONIDAL CYST COMPLEX,6001260,CDM,10081,CPT,Facility,outpatient,,,,1906.97,953.49,,,,,,,,,,,,
I&D HEMATOMA/SEROMA,6001261,CDM,10140,CPT,Facility,outpatient,,,,1680,840,,,,,,,,,,,,
PUNCTURE AS ABSCESS/CYST,6001262,CDM,10160,CPT,Facility,outpatient,,,,375,187.5,,,,,,,,,,,,
PUNCH BIOPSY SKIN EA SEP/ADD,6001266,CDM,11732,CPT,Facility,outpatient,,,,95,47.5,,,,,,,,,,,,
INCIS BIOP SKIN EA SEP/ADD,6001268,CDM,51703,CPT,Facility,both,,,,471,235.5,,,,,,,,,,,,
DRESS/DEB PARL BURNS>10% BS,6001270,CDM,16030,CPT,Facility,outpatient,,,,985,492.5,,,,,,,,,,,,
LAC SIMPLE SCA 20.1-30.0,6001271,CDM,12006,CPT,Facility,outpatient,,,,1799,899.5,,,,,,,,,,,,
SIMPLE REP OVER 30 CM,6001272,CDM,12007,CPT,Facility,outpatient,,,,1114,557,,,,,,,,,,,,
LAC SIMPLE <=2.5,6001273,CDM,12001,CPT,Facility,outpatient,,,,550.2,275.1,,,,,,,,,,,,
LAC SIMP 12.6-20.0CM,6001274,CDM,12016,CPT,Facility,outpatient,,,,1410,705,,,,,,,,,,,,
LAC SIMP  20.1-30.0CM,6001275,CDM,12017,CPT,Facility,outpatient,,,,1823,911.5,,,,,,,,,,,,
"TX SUP WOUND, PACKING",6001278,CDM,12021,CPT,Facility,outpatient,,,,683,341.5,,,,,,,,,,,,
LAC INTER/TK/EXT 20.1-30.0,6001279,CDM,12036,CPT,Facility,outpatient,,,,1476,738,,,,,,,,,,,,
"LAYER CLOSURE, OVER 30 CM",6001280,CDM,12037,CPT,Facility,outpatient,,,,1724,862,,,,,,,,,,,,
LAC COMPLEX FACE EA ADDL 5CM,6001291,CDM,13153,CPT,Facility,outpatient,,,,797,398.5,,,,,,,,,,,,
STRAPPING HIP,6001295,CDM,29520,CPT,Facility,outpatient,,,,139,69.5,,,,,,,,,,,,
ER LEVEL 2,6001304,CDM,99282,CPT,Facility,both,,,,402.45,201.23,,,,,,,,,,,,
ER LEVEL 3,6001305,CDM,99283,CPT,Facility,both,,,,709.05,354.53,,,,,,,,,,,,
ER LEVEL 4,6001306,CDM,99284,CPT,Facility,both,,,,1114.59,557.3,,,,,,,,,,,,
ER LEVEL 5,6001307,CDM,99285,CPT,Facility,both,,,,1599.81,799.91,,,,,,,,,,,,
CLOSED TX DIST FX W/MANP EA,6001312,CDM,26755,CPT,Facility,both,,,,1051,525.5,,,,,,,,,,,,
REPAIR LIP OVER 1/2 OR COMPLEX,6001313,CDM,40654,CPT,Facility,both,,,,3440,1720,,,,,,,,,,,,
REMOVAL SKIN TAG 1-15,6001320,CDM,11200,CPT,Facility,outpatient,,,,216,108,,,,,,,,,,,,
FB REMOVAL MUSC SHEATH SIMPLE,6001332,CDM,10120,CPT,Facility,outpatient,,,,1765,882.5,,,,,,,,,,,,
CLOSED TX ULNAR FX W/O MANIP,6001345,CDM,24670,CPT,Facility,inpatient,,,,1018,509,,,,,,,,,,,,
DRAINAGE FINGER ABSCESS SIMPLE,6001353,CDM,26010,CPT,Facility,both,,,,875,437.5,,,,,,,,,,,,
CLOSED TX FEMUR FX W/O MANIP,6001359,CDM,27508,CPT,Facility,inpatient,,,,1965,982.5,,,,,,,,,,,,
CLOSED TXTIBIA FX W/O MANIP,6001368,CDM,27824,CPT,Facility,inpatient,,,,1257,628.5,,,,,,,,,,,,
FB REMOVAL PHARYNX,6001392,CDM,42809,CPT,Facility,both,,,,831.54,415.77,,,,,,,,,,,,
I&D ABSCESS PERIANAL SU,6001398,CDM,46050,CPT,Facility,inpatient,,,,936,468,,,,,,,,,,,,
REMOVAL EYELID FOREIGN BODY,6001412,CDM,67938,CPT,Facility,both,,,,516,258,,,,,,,,,,,,
DEBRIDE INFECTED SKIN <10% BSA,6001452,CDM,11000,CPT,Facility,outpatient,,,,4170,2085,,,,,,,,,,,,
"CLSD TX FEMORAL FX, W/O MANIP",6001461,CDM,27230,CPT,Facility,inpatient,,,,1757,878.5,,,,,,,,,,,,
CLOSED TX RADIOCARPAL FRACTURE,6001467,CDM,25660,CPT,Facility,both,,,,1475,737.5,,,,,,,,,,,,
DESTRUCTION BENIGN LESION 1-14,6001515,CDM,17000,CPT,Facility,outpatient,,,,550.2,275.1,,,,,,,,,,,,
I&D EPIDIDYMIS TESTIS SCROTUM,6001555,CDM,54500,CPT,Facility,outpatient,,,,5485.95,2742.98,,,,,,,,,,,,
CLOSED TX OF HIP FX,6001577,CDM,27220,CPT,Facility,inpatient,,,,696,348,,,,,,,,,,,,
REMOVAL FOREIGN BODY RECTUM,6001585,CDM,45385,CPT,Facility,outpatient,,,,2431.44,1215.72,,,,,,,,,,,,
FB REM- MOUTH,6001590,CDM,42970,CPT,Facility,outpatient,,,,648.21,324.11,,,,,,,,,,,,
TX OF ORBIT FX W/O MANIP,6001592,CDM,21400,CPT,Facility,inpatient,,,,1132,566,,,,,,,,,,,,
TX OF ORBIT FX W/ MANIP,6001593,CDM,21401,CPT,Facility,inpatient,,,,1988,994,,,,,,,,,,,,
I&D UPPER ARM BURSA,6001596,CDM,23931,CPT,Facility,inpatient,,,,1000,500,,,,,,,,,,,,
EXCISION THROMBOSED HEMOS,6001597,CDM,46320,CPT,Facility,both,,,,554,277,,,,,,,,,,,,
Apply LngLegCastAmbType 29355,6120592,CDM,29355,CPT,Facility,both,,,,545.24,272.62,,,,,,,,,,,,
Apply Cylinder Cast 29365,6120593,CDM,29365,CPT,Facility,both,,,,234,117,,,,,,,,,,,,
Neuroplast/Trnsp UlnNrvW 64719,6120599,CDM,64719,CPT,Facility,both,,,,1592.24,796.12,,,,,,,,,,,,
Fluoro Guide Non-Spine 77002,6120608,CDM,77002,CPT,Facility,both,,,,323,161.5,,,,,,,,,,,,
Rem Ear Canal Lesion(s) 69145,6122168,CDM,69145,CPT,Facility,both,,,,1617.76,808.88,,,,,,,,,,,,
Laryngoscopy Dx (exc nb) 31525,6466423,CDM,31525,CPT,Facility,both,,,,979.92,489.96,,,,,,,,,,,,
Cld Tx Grtr Humeral Tubr 23620,6466597,CDM,23620,CPT,Facility,inpatient,,,,1065.92,532.96,,,,,,,,,,,,
Inj AnAgnt StellatGangln 64510,6504764,CDM,64510,CPT,Facility,both,,,,575.72,287.86,,,,,,,,,,,,
SmRpr S/N/A/G/T7.6-12.5CM12004,6600226,CDM,12004,CPT,Facility,outpatient,,,,667,333.5,,,,,,,,,,,,
RT CHARGE Chest PT Subseq,6690678,CDM,94668,CPT,Facility,both,,,,460.64,230.32,,,,,,,,,,,,
RT CHARGE Chest PT Init,6690679,CDM,94667,CPT,Facility,both,,,,460.64,230.32,,,,,,,,,,,,
CT LUMBAR SPINE WO/W,6708436,CDM,72133,CPT,Facility,both,,,,2018,1009,,,,,,,,,,,,
SmRpr S/N/A/G/T >30CM 12007,6898167,CDM,12007,CPT,Facility,outpatient,,,,1114,557,,,,,,,,,,,,
"Intubation, ET,Emergency 31500",6994896,CDM,31500,CPT,Facility,outpatient,,,,864.28,432.14,,,,,,,,,,,,
OFFICE/OUTPT VISIT EST 40MIN - SPECIALTY CLINIC,7000014,CDM,99215,CPT,Facility,both,,,,379,189.5,,,,,,,,,,,,
OP VISIT ESTAB PT EXPAND 15MIN - SPEC CLINIC,7000016,CDM,99213,CPT,Facility,both,,,,200,100,,,,,,,,,,,,
OP/OFVISIT EST PT FOC 10MIN - SPEC CLINIC,7000017,CDM,99212,CPT,Facility,both,,,,125,62.5,,,,,,,,,,,,
OFFICE/OUTPT VISIT NEW 30MIN- SPEC CLINIC,7000021,CDM,99203,CPT,Facility,both,,,,491,245.5,,,,,,,,,,,,
OP/OF VISIT NEW PT FOC 20MIN - SPEC CLINIC,7000022,CDM,99202,CPT,Facility,both,,,,329,164.5,,,,,,,,,,,,
NG TUBE INSERTION,7001022,CDM,43752,CPT,Facility,inpatient,,,,831.54,415.77,,,,,,,,,,,,
IV INFUSION THERAPY INITIAL HR,7001040,CDM,96365,CPT,Facility,outpatient,,,,508,254,,,,,,,,,,,,
OFFICE/OUTPT VISIT EST 5 MIN - SPEC CLINIC,7001098,CDM,99211,CPT,Facility,both,,,,89,44.5,,,,,,,,,,,,
OP/OF ESTAB PT DETAIL 25MIN,7001099,CDM,99214,CPT,Facility,both,,,,275,137.5,,,,,,,,,,,,
BLOOD ADMINISTRATION 0-4 HRS,7001110,CDM,36430,CPT,Facility,both,,,,111,55.5,,,,,,,,,,,,
BLOOD ADMINISTRATION 4-8 HRS,7001111,CDM,36430,CPT,Facility,both,,,,111,55.5,,,,,,,,,,,,
BLOOD ADMINISTRATION 8-12 HRS,7001112,CDM,36430,CPT,Facility,outpatient,,,,111,55.5,,,,,,,,,,,,
MCR ANNUAL WELL SUBSQ VISIT,7001198,CDM, G0439,HCPCS,Facility,outpatient,,,,234,117,,,,,,,,,,,,
MCR ANNUAL WELL 1ST VISIT,7001199,CDM, G0438,HCPCS,Facility,outpatient,,,,619,309.5,,,,,,,,,,,,
INITIAL TX 1ST DEGREE BURN,7500002,CDM,16020,CPT,Facility,outpatient,,,,270,135,,,,,,,,,,,,
ADVANCED CARE 1ST 30 MIN,7500003,CDM,99497,CPT,Facility,outpatient,,,,302.48,151.24,,,,,,,,,,,,
DRESS/DEB PARTIAL BURNS 5-10%,7500004,CDM,16020,CPT,Facility,outpatient,,,,505,252.5,,,,,,,,,,,,
ED Visit Level 1 - Pro,7500010,CDM,99281,CPT,Facility,both,,,,86.24,43.12,,,,,,,,,,,,
ED Visit Level 2 - Pro,7500011,CDM,99282,CPT,Facility,both,,,,402.45,201.23,,,,,,,,,,,,
ED Visit Level 3 - PRO,7500012,CDM,99283,CPT,Facility,both,,,,284.28,142.14,,,,,,,,,,,,
ED Visit Level 4 - Pro,7500013,CDM,99284,CPT,Facility,both,,,,480.4,240.2,,,,,,,,,,,,
ED Visit Level 5 - PRO,7500014,CDM,99285,CPT,Facility,both,,,,697.64,348.82,,,,,,,,,,,,
FB REMOVAL UPPER ARM SQ,7500020,CDM,10120,CPT,Facility,outpatient,,,,552.72,276.36,,,,,,,,,,,,
INSERT TEMP INDWEL CATH,7500021,CDM,51703,CPT,Facility,outpatient,,,,471,235.5,,,,,,,,,,,,
I&D HEMATOMA/SEROMA,7500040,CDM,10160,CPT,Facility,outpatient,,,,458.32,229.16,,,,,,,,,,,,
BLADDER IRRIGATION,7500063,CDM,51700,CPT,Facility,outpatient,,,,262,131,,,,,,,,,,,,
IP HOSP SUBQ DAY - LEVEL 3,7500104,CDM,99233,CPT,Facility,both,,,,398.04,199.02,,,,,,,,,,,,
IP HOSP INIT DAY - LEVEL 1,7500368,CDM,99221,CPT,Facility,both,,,,389.8,194.9,,,,,,,,,,,,
IP HOSP INIT DAY - LEVEL 3,7500369,CDM,99223,CPT,Facility,both,,,,770.16,385.08,,,,,,,,,,,,
SPECIAL CONSULTATION - LEVEL 1,7500370,CDM,99221,CPT,Facility,both,,,,500,250,,,,,,,,,,,,
IP HOSP SUBQ DAY - LEVEL 1,7500374,CDM,99231,CPT,Facility,both,,,,150.4,75.2,,,,,,,,,,,,
IP HOSP SUBQ DAY - LEVEL 2,7500375,CDM,99232,CPT,Facility,both,,,,276.96,138.48,,,,,,,,,,,,
IP DC DAY CARE - 30M OR LESS,7500376,CDM,99238,CPT,Facility,both,,,,278.6,139.3,,,,,,,,,,,,
IP DC DAY CARE - > 30 MINS,7500377,CDM,99239,CPT,Facility,both,,,,407.64,203.82,,,,,,,,,,,,
PHYS INITL SWING/NH MOD,7500389,CDM,99305,CPT,Facility,both,,,,497.88,248.94,,,,,,,,,,,,
PHYS SUBSEQ SWING/NH MOD,7500392,CDM,99308,CPT,Facility,both,,,,265.84,132.92,,,,,,,,,,,,
PHYS SUBSEQ SWING/NH HIG,7500393,CDM,99309,CPT,Facility,both,,,,350.48,175.24,,,,,,,,,,,,
SWING BED/NH DISCHARGE,7500395,CDM,99315,CPT,Facility,both,,,,279.88,139.94,,,,,,,,,,,,
EXC MALIG LESN TRNK/AR,7500437,CDM,11602,CPT,Facility,outpatient,,,,623.88,311.94,,,,,,,,,,,,
I&D EPIDIDYMIS TESTIS SCROTUM,7500627,CDM,54500,CPT,Facility,outpatient,,,,830.64,415.32,,,,,,,,,,,,
ER PHYSICIAN LEVEL 1,7501001,CDM,99281,CPT,Facility,outpatient,,,,86.24,43.12,,,,,,,,,,,,
APPLY FINGER SPLINT STATIC,7501006,CDM,29130,CPT,Facility,both,,,,173,86.5,,,,,,,,,,,,
APPLY SHORT ARM SPLINT,7501007,CDM,29125,CPT,Facility,both,,,,255,127.5,,,,,,,,,,,,
APPLY SHORT LEG SPLINT,7501009,CDM,29515,CPT,Facility,both,,,,39,19.5,,,,,,,,,,,,
APPLY LONG LEG SPLINT,7501010,CDM,29505,CPT,Facility,both,,,,197.92,98.96,,,,,,,,,,,,
TX SHOULDER W/MANIP&ANES,7501014,CDM,23500,CPT,Facility,outpatient,,,,1609.28,804.64,,,,,,,,,,,,
TX OF SHOULDER,7501015,CDM,23650,CPT,Facility,inpatient,,,,1564,782,,,,,,,,,,,,
I&D ABSCESS COMPLICATED,7501025,CDM,10062,CPT,Facility,outpatient,,,,967,483.5,,,,,,,,,,,,
"I&D ABSCESS SIMPLE, SNGL",7501026,CDM,10061,CPT,Facility,outpatient,,,,406,203,,,,,,,,,,,,
FB REMOVAL SQ TIS SIMPLE,7501028,CDM,10121,CPT,Facility,outpatient,,,,489,244.5,,,,,,,,,,,,
I&D BARTHOLIN CYST,7501029,CDM,56420,CPT,Facility,both,,,,521.97,260.99,,,,,,,,,,,,
LAC INTER NECK/HAND/FEET,7501030,CDM,12041,CPT,Facility,outpatient,,,,508,254,,,,,,,,,,,,
LAC SIMPLE SCALP/TRNK 2.6-7.5,7501031,CDM,12002,CPT,Facility,outpatient,,,,493,246.5,,,,,,,,,,,,
LAC SIMPLE SCALP/TRNK<=2.5CM,7501032,CDM,12001,CPT,Facility,outpatient,,,,403,201.5,,,,,,,,,,,,
LAC SIMPLE FACE/EAR/LIP 5.1-7,7501033,CDM,12014,CPT,Facility,outpatient,,,,459,229.5,,,,,,,,,,,,
LAC INTER FACE/EAR/LIP <=2.5,7501034,CDM,12051,CPT,Facility,outpatient,,,,600,300,,,,,,,,,,,,
LAC INTER SCLP/TK/EXT 7.6-12.5,7501035,CDM,12034,CPT,Facility,outpatient,,,,794.32,397.16,,,,,,,,,,,,
LAC INTER SCLP/TK/EXT 2.6-7.5,7501036,CDM,12032,CPT,Facility,outpatient,,,,730.12,365.06,,,,,,,,,,,,
LAC SIMPLE SCALP/TRNK 7.6-12.5,7501037,CDM,12004,CPT,Facility,outpatient,,,,605,302.5,,,,,,,,,,,,
LAC SIMPLE FACE/EAR/LIP 2.6-5,7501038,CDM,12013,CPT,Facility,outpatient,,,,527,263.5,,,,,,,,,,,,
REMOVAL FB FOOT SUBCUTANEOUS,7501040,CDM,28190,CPT,Facility,both,,,,516.72,258.36,,,,,,,,,,,,
FB REMOVAL EXT AUDITORY,7501041,CDM,69200,CPT,Facility,both,,,,184.56,92.28,,,,,,,,,,,,
FB REMOVAL EYE CONJUCTIVA,7501042,CDM,65205,CPT,Facility,both,,,,113.48,56.74,,,,,,,,,,,,
LAC SIMPLE FACE/EAR/LIP <=2.5,7501044,CDM,12011,CPT,Facility,outpatient,,,,216.88,108.44,,,,,,,,,,,,
STRAPPING SHOULDER,7501045,CDM,29240,CPT,Facility,both,,,,173,86.5,,,,,,,,,,,,
STRAPPING ANKLE AND OR FOOT,7501046,CDM,29540,CPT,Facility,both,,,,173,86.5,,,,,,,,,,,,
DEBRID SKIN/SQ TISSUE 1ST 20CM,7501049,CDM,11042,CPT,Facility,outpatient,,,,741,370.5,,,,,,,,,,,,
AVUL NAIL PLATE SINGLE SIMPLE,7501052,CDM,11730,CPT,Facility,outpatient,,,,215,107.5,,,,,,,,,,,,
EVAC SUBUNGUAL HEMATO,7501053,CDM,11740,CPT,Facility,outpatient,,,,121.28,60.64,,,,,,,,,,,,
EXCISION NAIL AND NAIL MATRIX,7501054,CDM,11750,CPT,Facility,outpatient,,,,475,237.5,,,,,,,,,,,,
LAC SIMPLE SCALP/TRNK 12.6-20,7501055,CDM,12005,CPT,Facility,outpatient,,,,818,409,,,,,,,,,,,,
LAC SIMPLE FACE/EAR/LIP,7501056,CDM,12015,CPT,Facility,outpatient,,,,372.24,186.12,,,,,,,,,,,,
LAC INTER SCLP/TK/EXT <2.5,7501057,CDM,12031,CPT,Facility,outpatient,,,,583.96,291.98,,,,,,,,,,,,
LAC RPR INTMD SCLP/TK/EXT,7501058,CDM,12035,CPT,Facility,outpatient,,,,1173,586.5,,,,,,,,,,,,
LAC INTER FACE/EAR/LIP 2.6-5,7501060,CDM,12052,CPT,Facility,outpatient,,,,769.8,384.9,,,,,,,,,,,,
LAC INTER FACE 12.6-20.0 CM,7501061,CDM,12055,CPT,Facility,outpatient,,,,1530,765,,,,,,,,,,,,
LAC COMPLEX SCALP/ARM/,7501064,CDM,13120,CPT,Facility,outpatient,,,,844,422,,,,,,,,,,,,
LAC COMPLEX SCALP/ARM,7501065,CDM,13121,CPT,Facility,outpatient,,,,1028,514,,,,,,,,,,,,
LAC COMP NECK/HAND/FT 2.6-7.5,7501067,CDM,13132,CPT,Facility,outpatient,,,,1174.08,587.04,,,,,,,,,,,,
ASP/INJECT INTERM JT/BURSA W,7501072,CDM,20605,CPT,Facility,both,,,,180,90,,,,,,,,,,,,
ASP/INJECT MAJOR JT/BURSA,7501073,CDM,20610,CPT,Facility,both,,,,216,108,,,,,,,,,,,,
TX MANDIBULAR FX W/O MANIP,7501077,CDM,21450,CPT,Facility,inpatient,,,,2942,1471,,,,,,,,,,,,
TX VERTEBRAL BODY FX,7501080,CDM,22310,CPT,Facility,inpatient,,,,1158.64,579.32,,,,,,,,,,,,
TX CLAVICULAR,7501081,CDM,23500,CPT,Facility,inpatient,,,,856,428,,,,,,,,,,,,
TX SCAPULAR FX W/O MANIP,7501082,CDM,23570,CPT,Facility,inpatient,,,,859,429.5,,,,,,,,,,,,
TX PROX HUMERAL FX,7501083,CDM,23600,CPT,Facility,inpatient,,,,790,395,,,,,,,,,,,,
TX HUMERAL SHA,7501084,CDM,24500,CPT,Facility,inpatient,,,,1314.88,657.44,,,,,,,,,,,,
TX NURSEMAID ELBOW W/ MANIP,7501085,CDM,24640,CPT,Facility,inpatient,,,,289,144.5,,,,,,,,,,,,
TX RADIAL HEAD/NECK,7501086,CDM,24650,CPT,Facility,inpatient,,,,604,302,,,,,,,,,,,,
TX RADIAL SHFT FX W/O M,7501088,CDM,25500,CPT,Facility,both,,,,938,469,,,,,,,,,,,,
TX ULNAR SHAFT FX W/O MANIP,7501089,CDM,25530,CPT,Facility,both,,,,564,282,,,,,,,,,,,,
TX RADIAL/ULNAR FX W/O MI,7501090,CDM,25560,CPT,Facility,both,,,,1014,507,,,,,,,,,,,,
TX COLLES FX W/O MAN,7501091,CDM,25605,CPT,Facility,outpatient,,,,2013.68,1006.84,,,,,,,,,,,,
TX CARPAL SCAPHOID FX W/O,7501092,CDM,25622,CPT,Facility,both,,,,1116,558,,,,,,,,,,,,
TX CARPAL BONE FX W/O MANIP EA,7501093,CDM,25630,CPT,Facility,both,,,,1089,544.5,,,,,,,,,,,,
TX METACARPAL FX W/O MANIP,7501097,CDM,26600,CPT,Facility,both,,,,630,315,,,,,,,,,,,,
TX METACARPOP DISL SINGLE,7501099,CDM,26700,CPT,Facility,both,,,,1230.36,615.18,,,,,,,,,,,,
TX PROXIMAL FINGER W/O  EA,7501100,CDM,26720,CPT,Facility,both,,,,739.48,369.74,,,,,,,,,,,,
TX INTERPHALANGEAL JT W/O ANES,7501102,CDM,26770,CPT,Facility,both,,,,1363,681.5,,,,,,,,,,,,
PATELLAR FX PF,7501106,CDM,27520,CPT,Facility,inpatient,,,,1163,581.5,,,,,,,,,,,,
TX OF PATELLAR DISLOCATION,7501107,CDM,27560,CPT,Facility,inpatient,,,,2246,1123,,,,,,,,,,,,
TX MEDIAL MALLEOLUS FX W/O,7501109,CDM,27760,CPT,Facility,outpatient,,,,1210.36,605.18,,,,,,,,,,,,
TX PROX FIBULA/SHAFT,7501110,CDM,27780,CPT,Facility,inpatient,,,,636,318,,,,,,,,,,,,
TX DISTAL FIB FX,7501111,CDM,27786,CPT,Facility,inpatient,,,,800,400,,,,,,,,,,,,
TX CALCANEAL FX W/O MANIP,7501114,CDM,28400,CPT,Facility,both,,,,953,476.5,,,,,,,,,,,,
TX METATARSAL FX W/,7501117,CDM,28485,CPT,Facility,outpatient,,,,802.04,401.02,,,,,,,,,,,,
TX GREAT TOE FX W/O MANIP,7501118,CDM,28490,CPT,Facility,both,,,,467,233.5,,,,,,,,,,,,
TX TOES 2-5 W/O MANIP EA,7501120,CDM,28510,CPT,Facility,both,,,,583,291.5,,,,,,,,,,,,
FB REMOVAL INTRANASAL,7501123,CDM,30300,CPT,Facility,both,,,,484.04,242.02,,,,,,,,,,,,
CONTROL NASAL HEM ANTERIOR,7501124,CDM,30901,CPT,Facility,both,,,,304,152,,,,,,,,,,,,
CONTROL NASAL HEM POSTERIOR,7501125,CDM,30905,CPT,Facility,both,,,,304,152,,,,,,,,,,,,
TUBE THORA CONNECT TO DRAIN,7501130,CDM,32551,CPT,Facility,inpatient,,,,614.2,307.1,,,,,,,,,,,,
INSERT NON-TUNNEL CENTRAL,7501135,CDM,36556,CPT,Facility,both,,,,163,81.5,,,,,,,,,,,,
I&D DENTAL ABSCESS,7501137,CDM,41800,CPT,Facility,both,,,,592.84,296.42,,,,,,,,,,,,
INSERT TEMP INDWEL CATH,7501142,CDM,51702,CPT,Facility,both,,,,379,189.5,,,,,,,,,,,,
TRIGEMINAL NERVE BLOCK,7501145,CDM,64400,CPT,Facility,outpatient,,,,315,157.5,,,,,,,,,,,,
REM IMPACT CERUMEN,7501153,CDM,69210,CPT,Facility,both,,,,43,21.5,,,,,,,,,,,,
OBS INITIAL LEVEL 1 PER DAY,7501160,CDM,99218,CPT,Facility,both,,,,379.99,190,,,,,,,,,,,,
OBS INITIAL LEVEL 3 PER DAY,7501162,CDM,99220,CPT,Facility,both,,,,695.84,347.92,,,,,,,,,,,,
OBS D/C DAY MGMT,7501163,CDM,99217,CPT,Facility,both,,,,325,162.5,,,,,,,,,,,,
OBS OR IP 1 DOS - LEVEL 3,7501166,CDM,99223,CPT,Facility,inpatient,,,,770.16,385.08,,,,,,,,,,,,
I&D ABSCESS PERIANAL,7501174,CDM,46050,CPT,Facility,inpatient,,,,391.56,195.78,,,,,,,,,,,,
PUNCTURE ASPIRATE ABSCESS/CYST,7501176,CDM,10060,CPT,Facility,outpatient,,,,375,187.5,,,,,,,,,,,,
TX DISTAL PHALA,7501178,CDM,26755,CPT,Facility,both,,,,1051,525.5,,,,,,,,,,,,
DISTAL FEMUR,7501182,CDM,27508,CPT,Facility,inpatient,,,,1965,982.5,,,,,,,,,,,,
TX DISTAL TIBIA,7501185,CDM,27824,CPT,Facility,inpatient,,,,1257,628.5,,,,,,,,,,,,
CLOSED TX ULNAR FX W/O MANIP,7501188,CDM,24670,CPT,Facility,inpatient,,,,1018,509,,,,,,,,,,,,
TX HUMERAL FX W/O MANIP,7501189,CDM,24530,CPT,Facility,inpatient,,,,950,475,,,,,,,,,,,,
TX DISTL RAD FX W/MN,7501192,CDM,25605,CPT,Facility,both,,,,2013.68,1006.84,,,,,,,,,,,,
DEBRIDE INFECTED SKIN,7501201,CDM,11042,CPT,Facility,outpatient,,,,567,283.5,,,,,,,,,,,,
EXCISED DIAMETER OVER,7501207,CDM,11046,CPT,Facility,outpatient,,,,216.64,108.32,,,,,,,,,,,,
DEBRIDE DKIN/SUBQ TISS O,7501208,CDM,11010,CPT,Facility,both,,,,1074.64,537.32,,,,,,,,,,,,
REMOVAL SKIN TAG 1-15,7501209,CDM,11200,CPT,Facility,outpatient,,,,216,108,,,,,,,,,,,,
EYE LID/ REMOVAL FOREIGN,7501210,CDM,67938,CPT,Facility,both,,,,449.16,224.58,,,,,,,,,,,,
FB REMOVAL PHARYNX,7501223,CDM,42809,CPT,Facility,inpatient,,,,831.54,415.77,,,,,,,,,,,,
"I&D PILONIDAL CYST, SIMPLE",7501224,CDM,56405,CPT,Facility,outpatient,,,,624,312,,,,,,,,,,,,
VAGINAL DELIVERY,7501238,CDM,59409,CPT,Facility,both,,,,2087,1043.5,,,,,,,,,,,,
LACERATION REPAIR LIP UP TO,7501245,CDM,40654,CPT,Facility,both,,,,3440,1720,,,,,,,,,,,,
STRAPPING KNEE,7501284,CDM,29530,CPT,Facility,both,,,,173,86.5,,,,,,,,,,,,
STRAPPING HAND OR FINGER,7501286,CDM,29280,CPT,Facility,both,,,,193,96.5,,,,,,,,,,,,
NERVE BLOCK GREATER OCCIP,7501323,CDM,64405,CPT,Facility,both,,,,206.6,103.3,,,,,,,,,,,,
DRAINAGE FINGER ABSCESS,7501324,CDM,10060,CPT,Facility,outpatient,,,,548.72,274.36,,,,,,,,,,,,
ZZ OBS CARE SUB LOW/FOCUSED PF,7501331,CDM,99224,CPT,Facility,both,,,,151.68,75.84,,,,,,,,,,,,
Replacement of gastrostomy tube,7501403,CDM,43762,CPT,Facility,inpatient,,,,946,473,,,,,,,,,,,,
Tangential biopsy of skin,7501404,CDM,11102,CPT,Facility,outpatient,,,,238,119,,,,,,,,,,,,
Cl tx Radl Shaft Fx w/mn 25505,7501407,CDM,25505,CPT,Facility,both,,,,1808,904,,,,,,,,,,,,
Drainage of abscess,7501408,CDM,41800,CPT,Facility,both,,,,616,308,,,,,,,,,,,,
injection(s) peripheral nerve,7501409,CDM,64450,CPT,Facility,both,,,,1109,554.5,,,,,,,,,,,,
PICC,7501410,CDM,36569,CPT,Facility,both,,,,297,148.5,,,,,,,,,,,,
"Repair, wounds face  5.1 cm to 7.5 cm",7501411,CDM,12053,CPT,Facility,outpatient,,,,828,414,,,,,,,,,,,,
Repair wounds face 7.6 cm to 12.5 cm,7501412,CDM,12054,CPT,Facility,outpatient,,,,1207,603.5,,,,,,,,,,,,
Repair wounds face 20.1 cm to 30.0 cm,7501413,CDM,12056,CPT,Facility,outpatient,,,,2080,1040,,,,,,,,,,,,
"Repair, complex, trunk; 2.6 cm to 7.5 cm",7501414,CDM,13101,CPT,Facility,outpatient,,,,951,475.5,,,,,,,,,,,,
Repair trunk; additional 5 cm or less,7501415,CDM,13102,CPT,Facility,outpatient,,,,245,122.5,,,,,,,,,,,,
Repair scalp/arm/leg extra 5 cm or less,7501416,CDM,13122,CPT,Facility,outpatient,,,,336,168,,,,,,,,,,,,
"Repair, complex, additional 5 cm or less",7501417,CDM,13133,CPT,Facility,outpatient,,,,627,313.5,,,,,,,,,,,,
"Repair, complex, face; 1.1 cm to 2.5 cm",7501418,CDM,13151,CPT,Facility,outpatient,,,,1019,509.5,,,,,,,,,,,,
I&D SCROTAL ABSCESS,7501419,CDM,54500,CPT,Facility,outpatient,,,,651.16,325.58,,,,,,,,,,,,
AC Joint/bursa w/ US 20611,7501420,CDM,20611,CPT,Facility,both,,,,2238,1119,,,,,,,,,,,,
Asp/Inj GanglionCyst Any 20612,7501421,CDM,20612,CPT,Facility,both,,,,2238,1119,,,,,,,,,,,,
"Repair, complex, face; 2.6 cm to 7.5 cm",7501422,CDM,13152,CPT,Facility,outpatient,,,,1400,700,,,,,,,,,,,,
Repair wounds face 20.1 cm to 30.0 cm,7501423,CDM,12056,CPT,Facility,outpatient,,,,2080,1040,,,,,,,,,,,,
"Repair, complex, trunk; 2.6 cm to 7.5 cm",7501424,CDM,13101,CPT,Facility,outpatient,,,,951,475.5,,,,,,,,,,,,
PICC LINE W/OUT SUB-Q W,7501514,CDM,36573,CPT,Facility,both,,,,143,71.5,,,,,,,,,,,,
Repair trunk; additional 5 cm or less,7501525,CDM,13102,CPT,Facility,outpatient,,,,245,122.5,,,,,,,,,,,,
Repair scalp/arm/leg extra 5 cm or less,7501526,CDM,13122,CPT,Facility,outpatient,,,,336,168,,,,,,,,,,,,
"Repair, complex, additional 5 cm or less",7501527,CDM,13133,CPT,Facility,outpatient,,,,627,313.5,,,,,,,,,,,,
"Repair, complex, face; 1.1 cm to 2.5 cm",7501528,CDM,13151,CPT,Facility,outpatient,,,,1019,509.5,,,,,,,,,,,,
"Repair, complex, face; 2.6 cm to 7.5 cm",7501529,CDM,13152,CPT,Facility,outpatient,,,,1400,700,,,,,,,,,,,,
TX OF ORBIT FX W/ MANIP,7517251,CDM,21401,CPT,Facility,inpatient,,,,1988,994,,,,,,,,,,,,
ROOM/BED: Nursery Level I,7582545,CDM,,,Facility,both,,,,2949,1474.5,,,,,,,,,,,,
ROOM/BED: Swing Bed (SNF),7582557,CDM,,,Facility,both,,,,2456,1228,,,,,,,,,,,,
TX OF ORBIT FX W/O MANIP,7599210,CDM,21400,CPT,Facility,inpatient,,,,1132,566,,,,,,,,,,,,
OPEN OLECRANON DISPLACED FX,7599228,CDM,24685,CPT,Facility,inpatient,,,,2560.72,1280.36,,,,,,,,,,,,
I&D UPPER ARM BURSA,7599229,CDM,23931,CPT,Facility,inpatient,,,,1000,500,,,,,,,,,,,,
"TX FEMORAL FX, W/O MANIP",7599329,CDM,27230,CPT,Facility,inpatient,,,,1757,878.5,,,,,,,,,,,,
TX RADIOCARPAL FRACTURE,7599338,CDM,25660,CPT,Facility,both,,,,1475,737.5,,,,,,,,,,,,
EXCISION THROMBOSED HEM,7599339,CDM,46320,CPT,Facility,both,,,,554,277,,,,,,,,,,,,
Annual Medicare Wellness Visit,7599340,CDM,G0438,HCPCS,Facility,both,,,,619,309.5,,,,,,,,,,,,
Subsequent Annual Wellness Visit,7599341,CDM,G0439,HCPCS,Facility,both,,,,234,117,,,,,,,,,,,,
Ventilator Charge Initial,7809303,CDM,94002,CPT,Facility,both,,,,1990.16,995.08,,,,,,,,,,,,
PT/OT TELE SELF CARE,7809307,CDM,97535,CPT,Facility,both,,,,90,45,,,,,,,,,,,,
PT/OT TELE THER ACT,7809308,CDM,97530,CPT,Facility,both,,,,140,70,,,,,,,,,,,,
PT/OT TELE GAIT TRAIN,7809309,CDM,97116,CPT,Facility,both,,,,121,60.5,,,,,,,,,,,,
Apply fluor varn pri tth 99188,7810119,CDM,99188,CPT,Facility,both,,,,53,26.5,,,,,,,,,,,,
Shv Lesn S/n/h/ft/g >2cm 11308,7817468,CDM,11308,CPT,Facility,both,,,,106,53,,,,,,,,,,,,
Clsd Tx Clav Fx w/o Mani 23500,7817470,CDM,23500,CPT,Facility,inpatient,,,,893.04,446.52,,,,,,,,,,,,
Init Nursing Facil Cr LO 99304,7817474,CDM,99304,CPT,Facility,both,,,,344.84,172.42,,,,,,,,,,,,
PULM Rehab Leg Lifter,7819222,CDM,,,Facility,both,,,,50,25,,,,,,,,,,,,
PULM Rehab Reacher Featherwgt,7819226,CDM,,,Facility,both,,,,46,23,,,,,,,,,,,,
PULM Rehab Sock Aid,7819228,CDM,,,Facility,both,,,,41,20.5,,,,,,,,,,,,
Peak Flow POC,7824667,CDM,94060,CPT,Facility,both,,,,468,234,,,,,,,,,,,,
Urine Drug Screen POC,7824677,CDM,80305,CPT,Facility,both,,,,100,50,,,,,,,,,,,,
ROOM/BED: Med/Surg Level 1,7851325,CDM,,,Facility,both,,,,2949,1474.5,,,,,,,,,,,,
ROOM/BED: Med/Surg Lv 2 w/Tele,7851326,CDM,,,Facility,both,,,,2949,1474.5,,,,,,,,,,,,
RT Non-invasive Managmnt CPAP,7853691,CDM,94660,CPT,Facility,both,,,,767.88,383.94,,,,,,,,,,,,
DE-GROUP DIABETES ED /30M,7858807,CDM,g0109,HCPCS,Facility,both,,,,61.44,30.72,,,,,,,,,,,,
DE-DIABETES ED INDIVID /30M,7858808,CDM,g0108,HCPCS,Facility,both,,,,216.32,108.16,,,,,,,,,,,,
"DE-MNT, GROUP PER 30 MINUTES",7858842,CDM,g0109,HCPCS,Facility,both,,,,61.2,30.6,,,,,,,,,,,,
DE-NTR Beh. Therapy (G0447),7859977,CDM,G0447,HCPCS,Facility,both,,,,229.26,114.63,,,,,,,,,,,,
NSF CHARGE,7880037,CDM,,,Facility,both,,,,25,12.5,,,,,,,,,,,,
RT ArslTx InhPentamidine 94642,7880372,CDM,94642,CPT,Facility,both,,,,767.88,383.94,,,,,,,,,,,,
RT Aerosol Demo/Eval MDI Demo,7880385,CDM,94664,CPT,Facility,both,,,,767.88,383.94,,,,,,,,,,,,
RT Continuous Inhl Subsq 94645,7880397,CDM,94645,CPT,Facility,both,,,,60.24,30.12,,,,,,,,,,,,
RT Continuous Inhal init 94644,7880398,CDM,94644,CPT,Facility,both,,,,460.64,230.32,,,,,,,,,,,,
RT Vent Management Subsequent,7880426,CDM,94003,CPT,Facility,both,,,,1990.16,995.08,,,,,,,,,,,,
RT Smoke/TobaccCnsl 3-10 99406,7882294,CDM,99406,CPT,Facility,both,,,,107.36,53.68,,,,,,,,,,,,
RT Smoke/Tobacco Cnsl>10 99407,7882295,CDM,99407,CPT,Facility,both,,,,107.36,53.68,,,,,,,,,,,,
RT Supplies  Venturi Mask,7882314,CDM,,,Facility,both,,,,39,19.5,,,,,,,,,,,,
RT Supplies  STAT CO2 Detector,7882317,CDM,,,Facility,both,,,,57,28.5,,,,,,,,,,,,
RT Supplies  Simple mask,7882318,CDM,,,Facility,both,,,,32,16,,,,,,,,,,,,
RT Supplies  Oxygen Humidifier,7882320,CDM,,,Facility,both,,,,45,22.5,,,,,,,,,,,,
RT Suppl Mini Hrt HIFlow Pedi,7882321,CDM,,,Facility,both,,,,44,22,,,,,,,,,,,,
RT Supplies  Mask BiPap,7882323,CDM,,,Facility,both,,,,141,70.5,,,,,,,,,,,,
RT Supplies  Humidifier,7882324,CDM,,,Facility,both,,,,118,59,,,,,,,,,,,,
RT Supplies  H20 Trap Kit,7882326,CDM,,,Facility,both,,,,32,16,,,,,,,,,,,,
RT Supplies  Face tent,7882327,CDM,,,Facility,both,,,,39,19.5,,,,,,,,,,,,
RT Supplies  Face mask,7882328,CDM,,,Facility,both,,,,36,18,,,,,,,,,,,,
RT Supplies Endotrach Fastener,7882329,CDM,,,Facility,both,,,,39,19.5,,,,,,,,,,,,
RT Supplies  Disposable Spiro,7882330,CDM,,,Facility,both,,,,76,38,,,,,,,,,,,,
RT Supplies Dispos Ambu Bags,7882331,CDM,,,Facility,both,,,,44,22,,,,,,,,,,,,
RT Supplies  CO2 Sensor,7882334,CDM,,,Facility,both,,,,60,30,,,,,,,,,,,,
RT Supplies CO2 Detector Adult,7882335,CDM,,,Facility,both,,,,59,29.5,,,,,,,,,,,,
RT Suppl Cannula Nsl Optiflow,7882336,CDM,,,Facility,both,,,,77,38.5,,,,,,,,,,,,
RT Supplies Aerochamber Spacer,7882338,CDM,,,Facility,both,,,,30,15,,,,,,,,,,,,
RT Suppl Acapella Airway Dev,7882339,CDM,,,Facility,both,,,,151,75.5,,,,,,,,,,,,
Inc&Dr Rectal Abscess 45005,7887681,CDM,45005,CPT,Facility,inpatient,,,,1266.2,633.1,,,,,,,,,,,,
UA DIPSTICK NON-AUTO W/O MICRO,8001001,CDM,81002,CPT,Facility,both,,,,32,16,,,,,,,,,,,,
BLOOD OCCULT STOOL 1-3,8001003,CDM,82270,CPT,Facility,both,,,,17.52,8.76,,,,,,,,,,,,
OFC ESTAB LEVEL 1,8001006,CDM,99211,CPT,Facility,both,,,,89,44.5,,,,,,,,,,,,
OFC ESTAB LEVEL 2,8001007,CDM,99212,CPT,Facility,both,,,,125,62.5,,,,,,,,,,,,
OFC ESTAB LEVEL 3,8001008,CDM,99213,CPT,Facility,both,,,,200,100,,,,,,,,,,,,
OFC ESTAB LEVEL 4,8001009,CDM,99214,CPT,Facility,both,,,,275,137.5,,,,,,,,,,,,
OFC ESTAB LEVEL 5,8001010,CDM,99215,CPT,Facility,outpatient,,,,379,189.5,,,,,,,,,,,,
OFC NEW LEVEL 1,8001011,CDM,99202,CPT,Facility,both,,,,329,164.5,,,,,,,,,,,,
OFC NEW LEVEL 2,8001012,CDM,99202,CPT,Facility,both,,,,329,164.5,,,,,,,,,,,,
OFC NEW LEVEL 3,8001013,CDM,99203,CPT,Facility,both,,,,491,245.5,,,,,,,,,,,,
OFC NEW LEVEL 4,8001014,CDM,99204,CPT,Facility,both,,,,598,299,,,,,,,,,,,,
OFC NEW LEVEL 5,8001015,CDM,99205,CPT,Facility,both,,,,598,299,,,,,,,,,,,,
I&D ABSCESS SIMPLE,8001021,CDM,10061,CPT,Facility,outpatient,,,,713.28,356.64,,,,,,,,,,,,
REMOVAL SKIN TAG 1-15,8001022,CDM,11200,CPT,Facility,outpatient,,,,216,108,,,,,,,,,,,,
EX B9 LESN  0.5CM OR <,8001023,CDM,11400,CPT,Facility,outpatient,,,,365,182.5,,,,,,,,,,,,
EX B9 LESN TRNK/ARM/LEG.6-1,8001024,CDM,11401,CPT,Facility,outpatient,,,,445,222.5,,,,,,,,,,,,
EX B9 LESN TRNK/ARM/LEG 1.1-2.,8001025,CDM,11402,CPT,Facility,outpatient,,,,504,252,,,,,,,,,,,,
AVUL NAIL PLATE SINGLE SIMPLE,8001026,CDM,11730,CPT,Facility,outpatient,,,,215,107.5,,,,,,,,,,,,
TB SKIN TEST,8001033,CDM,86580,CPT,Facility,both,,,,65,32.5,,,,,,,,,,,,
PULSE OXIMETRY,8001037,CDM,94760,CPT,Facility,both,,,,37,18.5,,,,,,,,,,,,
REM IMPACT CERUMEN W/IN UNI,8001045,CDM,69209,CPT,Facility,outpatient,,,,284.25,142.13,,,,,,,,,,,,
ASP/INJECT SMALL W/O US GUI,8001046,CDM,20600,CPT,Facility,outpatient,,,,1334.15,667.08,,,,,,,,,,,,
ASP/INJECT INTERM W/O US GUI,8001047,CDM,20605,CPT,Facility,both,,,,180,90,,,,,,,,,,,,
ASP/INJECT MAJOR  W/O US GUI,8001048,CDM,20610,CPT,Facility,outpatient,,,,216,108,,,,,,,,,,,,
FB REMSQ TIS SIMPLE W/INCISION,8001052,CDM,10060,CPT,Facility,outpatient,,,,489,244.5,,,,,,,,,,,,
INC THRO HEMORRHOID EXTL,8001056,CDM,46083,CPT,Facility,outpatient,,,,458,229,,,,,,,,,,,,
LAC COMPLEX TRUNK 1.1-2.5CM,8001058,CDM,13100,CPT,Facility,outpatient,,,,793,396.5,,,,,,,,,,,,
LAC SIMPLE SCAK<=2.5CM,8001060,CDM,12001,CPT,Facility,outpatient,,,,917,458.5,,,,,,,,,,,,
PHYS INITL SWH MOD 35MIN,8001066,CDM,99305,CPT,Facility,both,,,,622.35,311.18,,,,,,,,,,,,
SPORTS PHYSICAL,8001076,CDM,99070,CPT,Facility,outpatient,,,,32,16,,,,,,,,,,,,
HEMOGLOBIN A1C GLYCATED,8001080,CDM,83036,CPT,Facility,both,,,,123,61.5,,,,,,,,,,,,
URINALYSIS NON-AUTO W/MICRO,8001081,CDM,81000,CPT,Facility,both,,,,38,19,,,,,,,,,,,,
ALBUMIN,8001082,CDM,82105,CPT,Facility,outpatient,,,,69.08,34.54,,,,,,,,,,,,
LAC SIMPLE SCALP/TRNK 2.6-7.5,8001087,CDM,12034,CPT,Facility,outpatient,,,,794.32,397.16,,,,,,,,,,,,
LAC SIMPLE SCALP/TRNK 7.6-12.5,8001088,CDM,12035,CPT,Facility,outpatient,,,,667,333.5,,,,,,,,,,,,
LAC SIMPLE FACE/EAR/LIP <=2.5,8001090,CDM,12001,CPT,Facility,outpatient,,,,917,458.5,,,,,,,,,,,,
LAC SIMPLE FACE/EAR/LIP 2.6-5,8001091,CDM,12002,CPT,Facility,outpatient,,,,709,354.5,,,,,,,,,,,,
LAC SIMPLE FACE/EAR/LIP 5.1-7,8001092,CDM,12004,CPT,Facility,outpatient,,,,628,314,,,,,,,,,,,,
EX B9 LESN TRK/ARM/LEG 2.1-3.0,8001094,CDM,11403,CPT,Facility,outpatient,,,,458,229,,,,,,,,,,,,
EX B9 LESN SC <0.5CM,8001097,CDM,11420,CPT,Facility,outpatient,,,,272,136,,,,,,,,,,,,
EX B9 LESN SC .6-1,8001098,CDM,11421,CPT,Facility,outpatient,,,,465,232.5,,,,,,,,,,,,
EX B9 LESN SCL 1.1-2,8001099,CDM,11422,CPT,Facility,outpatient,,,,426,213,,,,,,,,,,,,
EX B9 LESN SCL 2.1-3.0,8001100,CDM,11423,CPT,Facility,outpatient,,,,596,298,,,,,,,,,,,,
INITIAL PREV E&M NEW 18-39,8001101,CDM,99385,CPT,Facility,outpatient,,,,150,75,,,,,,,,,,,,
EX B9 LESN FACE <.5CM,8001103,CDM,11440,CPT,Facility,outpatient,,,,428,214,,,,,,,,,,,,
EX B9 LESN FACE .6-1CM,8001104,CDM,11441,CPT,Facility,outpatient,,,,408,204,,,,,,,,,,,,
EX B9 LESN FACE 1.1-2.0CM,8001105,CDM,11442,CPT,Facility,outpatient,,,,452,226,,,,,,,,,,,,
INJ TENDON SHEATH/LIGAMENT,8001106,CDM,20527,CPT,Facility,outpatient,,,,180,90,,,,,,,,,,,,
DESTRUCT PRE- LESION 1ST LESN,8001107,CDM,17000,CPT,Facility,outpatient,,,,160,80,,,,,,,,,,,,
DEST PRE-MALIG LESION 2-14 EA,8001108,CDM,17003,CPT,Facility,outpatient,,,,22.45,11.23,,,,,,,,,,,,
I&D ABSCESS COMPLICATED/MULTI,8001110,CDM,10061,CPT,Facility,outpatient,,,,967,483.5,,,,,,,,,,,,
I&D HEMATOMA/SEROMA,8001111,CDM,10060,CPT,Facility,outpatient,,,,458.32,229.16,,,,,,,,,,,,
APPLY SHORT ARM SPLINT,8001237,CDM,29505,CPT,Facility,outpatient,,,,575.8,287.9,,,,,,,,,,,,
"GLUCOSE, WHOLE BLOOD",8001246,CDM,82962,CPT,Facility,outpatient,,,,22.5,11.25,,,,,,,,,,,,
BREATHING TREATMENT,8001248,CDM,94640,CPT,Facility,outpatient,,,,959.85,479.93,,,,,,,,,,,,
IMMUNIZATION ADMINISTRATION,8001291,CDM,90471,CPT,Facility,both,,,,25,12.5,,,,,,,,,,,,
STRAPPING ELBOW OR WRIST,8001369,CDM,29260,CPT,Facility,both,,,,54,27,,,,,,,,,,,,
2nd dose covid vaccine,8001565,CDM,91300,CPT,Facility,outpatient,,,,28.39,14.2,,,,,,,,,,,,
VENIPUNCTURE,8001600,CDM,36410,CPT,Facility,outpatient,,,,140,70,,,,,,,,,,,,
URINE VOLUME MEASURMENT,8001601,CDM,81000,CPT,Facility,outpatient,,,,21,10.5,,,,,,,,,,,,
MCR ANNUAL WELL 1ST VISIT,8001602,CDM,G0439,HCPCS,Facility,outpatient,,,,234,117,,,,,,,,,,,,
MCR ANNUAL WELL SUBSQ VISIT,8001603,CDM,G0438,HCPCS,Facility,outpatient,,,,619,309.5,,,,,,,,,,,,
Pure tone audiometry,8001701,CDM,92551,CPT,Facility,outpatient,,,,18.24,9.12,,,,,,,,,,,,
DRESS/DEB PAL BURNS>10% BS,8001740,CDM,16000,CPT,Facility,outpatient,,,,985,492.5,,,,,,,,,,,,
ANOSCOPY DIAG BRUSH/WASH,8001763,CDM,46600,CPT,Facility,both,,,,340,170,,,,,,,,,,,,
COVID VACC BOOSTER ADMIN,8001767,CDM,0064A,HCPCS,Facility,both,,,,175,87.5,,,,,,,,,,,,
1ST COVID,8001770,CDM,91300,CPT,Facility,outpatient,,,,53,26.5,,,,,,,,,,,,
CHLAMYDIA TRACH AMP PROBE,8002357,CDM,87490,CPT,Facility,both,,,,115,57.5,,,,,,,,,,,,
NEISSERIA GONORRHEA AMP PROBE,8002358,CDM,87591,CPT,Facility,both,,,,91,45.5,,,,,,,,,,,,
EMPL PHYSICAL CLIENT,8002359,CDM,,,Facility,both,,,,99,49.5,,,,,,,,,,,,
FIT FORM CLIENT,8002360,CDM,,,Facility,both,,,,10,5,,,,,,,,,,,,
FIT TESTING CLIENT,8002361,CDM,,,Facility,both,,,,10,5,,,,,,,,,,,,
EKG COMPLETE CLIENT,8002362,CDM,,,Facility,both,,,,316,158,,,,,,,,,,,,
PPD CLIENT,8002363,CDM,,,Facility,both,,,,19,9.5,,,,,,,,,,,,
HEARING TEST CLIENT,8002364,CDM,,,Facility,both,,,,45,22.5,,,,,,,,,,,,
CDL PHYSICAL CLIENT,8002365,CDM,,,Facility,both,,,,99,49.5,,,,,,,,,,,,
URINE DRUG SCREEN CLIENT,8002366,CDM,,,Facility,both,,,,45,22.5,,,,,,,,,,,,
ALCOHOL BREATHALYZER CLIENT,8002367,CDM,,,Facility,both,,,,50,25,,,,,,,,,,,,
97032-OCC THER E-STIM (MANUAL),8010214,CDM,97032,CPT,Facility,both,,,,117,58.5,,,,,,,,,,,,
97014-OCC THER E-STIM (UNATTEN,8010215,CDM,97014,CPT,Facility,both,,,,99,49.5,,,,,,,,,,,,
97010-OCC THER HOT/COLD PACK A,8010232,CDM,97010,CPT,Facility,both,,,,61,30.5,,,,,,,,,,,,
97033-OCC THER IONTOPHORESIS 1,8010233,CDM,97033,CPT,Facility,both,,,,140,70,,,,,,,,,,,,
97140-OCC THER MANUAL THERAPY 30min,8010243,CDM,97140,CPT,Facility,both,,,,242,121,,,,,,,,,,,,
97112-OCC THER NEUROMUSC RE-ED,8010248,CDM,97112,CPT,Facility,both,,,,146,73,,,,,,,,,,,,
G0283-OCC THER NON WND ELECT S,8010250,CDM,G0283,HCPCS,Facility,both,,,,98,49,,,,,,,,,,,,
97760-OCC THER ORTHOTIC MGT 15,8010253,CDM,97760,CPT,Facility,both,,,,138,69,,,,,,,,,,,,
97762-OCC THER ORTHOTIC RECHEC,8010254,CDM,97762,CPT,Facility,both,,,,322,161,,,,,,,,,,,,
97018-OCC THER PARAFIN TX,8010258,CDM,97018,CPT,Facility,both,,,,94,47,,,,,,,,,,,,
97761-OCC THER PROSTHETIC TRAI,8010265,CDM,97761,CPT,Facility,both,,,,118,59,,,,,,,,,,,,
97535-OCC THER SELF CARE HOME,8010272,CDM,97535,CPT,Facility,both,,,,105,52.5,,,,,,,,,,,,
29130-OCC THER STATIC FING SPL,8010279,CDM,29130,CPT,Facility,both,,,,460,230,,,,,,,,,,,,
29125-OCC THER STATIC SA SPLIN,8010281,CDM,29125,CPT,Facility,both,,,,311,155.5,,,,,,,,,,,,
29240-OCC THER STRAPPING SHOUL,8010283,CDM,29240,CPT,Facility,both,,,,173,86.5,,,,,,,,,,,,
97530-OCC THER THER ACTIVITY 1,8010293,CDM,97530,CPT,Facility,both,,,,140,70,,,,,,,,,,,,
97110-OCC THER THEREX 15M,8010294,CDM,97110,CPT,Facility,both,,,,140,70,,,,,,,,,,,,
97026-OCC THER TX INFRARED THE,8010300,CDM,97026,CPT,Facility,both,,,,43,21.5,,,,,,,,,,,,
97035-OCC THER ULTRASOUND 15 M,8010302,CDM,97035,CPT,Facility,both,,,,101,50.5,,,,,,,,,,,,
97034 PHYS THER CONT BATHS 15M,8010325,CDM,97034,CPT,Facility,both,,,,90,45,,,,,,,,,,,,
95992-PHYS THER EPLY MANUEVER,8010329,CDM,95992,CPT,Facility,both,,,,116,58,,,,,,,,,,,,
97032-PHYS THER E-STIM man 15m,8010330,CDM,97032,CPT,Facility,both,,,,117,58.5,,,,,,,,,,,,
97014-PHYS THER E-STIM UNATT,8010331,CDM,97014,CPT,Facility,both,,,,99,49.5,,,,,,,,,,,,
97116-PHYS THER GAIT TRAIN 30m,8010335,CDM,97116,CPT,Facility,both,,,,180,90,,,,,,,,,,,,
97010-PHYS THER HOT/COLD PACK,8010340,CDM,97010,CPT,Facility,both,,,,61,30.5,,,,,,,,,,,,
97033-PHYS THER IONTOPHORES15m,8010342,CDM,97033,CPT,Facility,both,,,,140,70,,,,,,,,,,,,
97140-PHYS THERMANTHERAPY 1 hr,8010349,CDM,97140,CPT,Facility,both,,,,360,180,,,,,,,,,,,,
97012-PHYS THER MECHANCL TRACT,8010351,CDM,97012,CPT,Facility,both,,,,99,49.5,,,,,,,,,,,,
97112-PHYS THER NRMSC RE-E 15m,8010357,CDM,97112,CPT,Facility,both,,,,146,73,,,,,,,,,,,,
97014-PHYS THER NON WND ELECT,8010359,CDM,97014,CPT,Facility,both,,,,99,49.5,,,,,,,,,,,,
97760-PHYS THER ORTHOT MGT 15M,8010361,CDM,97760,CPT,Facility,both,,,,138,69,,,,,,,,,,,,
97763 PHYS THER ORTHT RCHK 15M,8010362,CDM,97763,CPT,Facility,both,,,,113,56.5,,,,,,,,,,,,
97018-PHYS THER PARAFFIN,8010366,CDM,97018,CPT,Facility,both,,,,94,47,,,,,,,,,,,,
97750 PHYS THER PHYSICL PRF15M,8010367,CDM,97750,CPT,Facility,both,,,,143,71.5,,,,,,,,,,,,
97761-PHYS THER PROSTHET TRNG,8010372,CDM,97761,CPT,Facility,both,,,,118,59,,,,,,,,,,,,
97535-PHYS THER SELFCR HME 15M,8010378,CDM,97535,CPT,Facility,both,,,,105,52.5,,,,,,,,,,,,
29540-PT STRAP ANKLE/FOOT,8010383,CDM,29540,CPT,Facility,both,,,,173,86.5,,,,,,,,,,,,
29530-PHYS THER STRAPPING KNEE,8010384,CDM,29530,CPT,Facility,both,,,,173,86.5,,,,,,,,,,,,
29240-PT STRAPPNG SHOULDER,8010385,CDM,29240,CPT,Facility,both,,,,173,86.5,,,,,,,,,,,,
97110-PHYS THER THEREX 15 MIN,8010397,CDM,97110,CPT,Facility,both,,,,140,70,,,,,,,,,,,,
PHYS THER TX COLD/HOT PACK,8010399,CDM,97010,CPT,Facility,both,,,,183,91.5,,,,,,,,,,,,
97026-PHYS THER TX INFRARED TH,8010400,CDM,97026,CPT,Facility,both,,,,6.21,3.11,,,,,,,,,,,,
97035-PHYS THER ULTRASOUND 15M,8010401,CDM,97035,CPT,Facility,both,,,,101,50.5,,,,,,,,,,,,
PHYS THER UNNA BOOT APPL,8010402,CDM,29580,CPT,Facility,both,,,,168,84,,,,,,,,,,,,
97542-PHYS THER WHLCHR MGT 15M,8010403,CDM,97542,CPT,Facility,both,,,,111,55.5,,,,,,,,,,,,
INSERT URINARY CATHETER 51703,8016994,CDM,51703,CPT,Facility,both,,,,471,235.5,,,,,,,,,,,,
INS TMPINDWLLNG BLDRCATH 51702,8016995,CDM,51702,CPT,Facility,both,,,,379,189.5,,,,,,,,,,,,
INS NON-INDWELLING CATH 51701,8016996,CDM,51701,CPT,Facility,both,,,,262,131,,,,,,,,,,,,
RT Pulse Oximetry Single 94760,8019389,CDM,94760,CPT,Facility,outpatient,,,,12.28,6.14,,,,,,,,,,,,
RT Pulse Oximetry Overnite/Cnt,8019390,CDM,94762,CPT,Facility,outpatient,,,,570.36,285.18,,,,,,,,,,,,
RT Pulmonary StrsTst S 94617,8019391,CDM,94617,CPT,Facility,outpatient,,,,460.64,230.32,,,,,,,,,,,,
RT Lung Nitrogen Washout 94727,8019395,CDM,94727,CPT,Facility,outpatient,,,,570.36,285.18,,,,,,,,,,,,
RT Diffusing Cap (DLCO) 94729,8019397,CDM,94729,CPT,Facility,outpatient,,,,188.68,94.34,,,,,,,,,,,,
"RT Pulse Oximetry, Mult 94761",8019480,CDM,94761,CPT,Facility,outpatient,,,,9.51,4.76,,,,,,,,,,,,
RT Flow Volume Loop x2 94375,8019491,CDM,94375,CPT,Facility,outpatient,,,,810.87,405.44,,,,,,,,,,,,
RT Flow volume loop 94375,8019492,CDM,94375,CPT,Facility,outpatient,,,,810.87,405.44,,,,,,,,,,,,
RT Functional Residl VoL 94726,8019503,CDM,94726,CPT,Facility,outpatient,,,,1081.16,540.58,,,,,,,,,,,,
Teach MDI or Nebulizer 94664,8034947,CDM,94664,CPT,Facility,outpatient,,,,64.08,32.04,,,,,,,,,,,,
Skin Sub Grft F/N/H/F/G 15275,8035208,CDM,15275,CPT,Facility,both,,,,1962,981,,,,,,,,,,,,
Exc Nasal Polyp(s) Simp 30110,8047589,CDM,30110,CPT,Facility,both,,,,975.28,487.64,,,,,,,,,,,,
Exc Nck/ant thx SF< 5 cm 21556,8077534,CDM,21556,CPT,Facility,inpatient,,,,2108,1054,,,,,,,,,,,,
ABLATE INF TURBNT SUBMUC 30802,8078141,CDM,30802,CPT,Facility,both,,,,227,113.5,,,,,,,,,,,,
Anoscpy Dx wB/w Spc (sp) 46600,8078158,CDM,46600,CPT,Facility,both,,,,340,170,,,,,,,,,,,,
Arth Kne Lysis Adh (sep) 29884,8078274,CDM,29884,CPT,Facility,both,,,,117,58.5,,,,,,,,,,,,
Rem FB Intrnsl Req G Ans 30310,8078276,CDM,30310,CPT,Facility,both,,,,227,113.5,,,,,,,,,,,,
Freskn Manip w/Lys Prept 54450,8078336,CDM,54450,CPT,Facility,both,,,,176,88,,,,,,,,,,,,
Inj Epidurl Bld Clt Ptch 62273,8078344,CDM,62273,CPT,Facility,inpatient,,,,1685,842.5,,,,,,,,,,,,
US Transrectal 76872,8078363,CDM,76872,CPT,Facility,both,,,,435,217.5,,,,,,,,,,,,
Expl Postop H-Th-I Extr 35860,8078431,CDM,35860,CPT,Facility,both,,,,260,130,,,,,,,,,,,,
Insert Cent line w/ SC p 36563,8078440,CDM,36563,CPT,Facility,both,,,,117,58.5,,,,,,,,,,,,
Aspirate Pleura W/Imag 32555,8086004,CDM,32555,CPT,Facility,inpatient,,,,1260.52,630.26,,,,,,,,,,,,
RT VentManagementInitial 94002,8086701,CDM,94002,CPT,Facility,outpatient,,,,1990.16,995.08,,,,,,,,,,,,
RT Hot/Cool Mist Units,8095449,CDM,,,Facility,both,,,,39,19.5,,,,,,,,,,,,
RT Vent Setup SMH,8096608,CDM,,,Facility,both,,,,100,50,,,,,,,,,,,,
RT O2 Setup,8096634,CDM,,,Facility,both,,,,110,55,,,,,,,,,,,,
RT Nebulizer Setup Speare,8096670,CDM,,,Facility,both,,,,38,19,,,,,,,,,,,,
RT Assess and Treat 94664,8096803,CDM,94664,CPT,Facility,outpatient,,,,767.88,383.94,,,,,,,,,,,,
Excision/Curettage Phala 28108,8096875,CDM,28108,CPT,Facility,both,,,,1684.92,842.46,,,,,,,,,,,,
Cerumen Rem lavag unilat 69209,8100877,CDM,69209,CPT,Facility, outpatient,,,,43,21.5,,,,,,,,,,,,
Arthro Shoulder Srg Caps 29806,8100971,CDM,29806,CPT,Facility,both,,,,94,47,,,,,,,,,,,,
Apply PatllrTndnBrngcast 29435,8100972,CDM,29435,CPT,Facility,both,,,,318,159,,,,,,,,,,,,
Apply Finger Cast 29086,8100973,CDM,29086,CPT,Facility,both,,,,291.44,145.72,,,,,,,,,,,,
Inc BoneCortexHand/Fingr 26034,8101002,CDM,26034,CPT,Facility,both,,,,2739,1369.5,,,,,,,,,,,,
Drain Palmar Bursa Multi 26030,8101003,CDM,26030,CPT,Facility,both,,,,2719,1359.5,,,,,,,,,,,,
Exc Rcr GangWristDrsl/Vlr25112,8101012,CDM,25112,CPT,Facility,inpatient,,,,1721,860.5,,,,,,,,,,,,
ClTx Shldr Dislc+Fx w/M 23655,8101016,CDM,23655,CPT,Facility,inpatient,,,,1609.28,804.64,,,,,,,,,,,,
ClTx Greater HmrlTbFx W/M23625,8101017,CDM,23625,CPT,Facility,inpatient,,,,1514.44,757.22,,,,,,,,,,,,
Clsd Tx Clavicl Fx w/Man 23505,8101019,CDM,23505,CPT,Facility,inpatient,,,,1417.76,708.88,,,,,,,,,,,,
Inj AnsAgt Sciatic Nrv 1 64445,8101032,CDM,64445,CPT,Facility,both,,,,491.48,245.74,,,,,,,,,,,,
Anes Compl by Emergency 99140,8101056,CDM,99140,CPT,Facility,both,,,,513,256.5,,,,,,,,,,,,
RT CHARGE O2 Baby,8101134,CDM,,,Facility,both,,,,36,18,,,,,,,,,,,,
RT CHARGE O2 by Mask,8101137,CDM,,,Facility,both,,,,36,18,,,,,,,,,,,,
RT O2 Mother,8101139,CDM,,,Facility,both,,,,49,24.5,,,,,,,,,,,,
RT CHARGE ED/OP ROOM O2,8101141,CDM,,,Facility,both,,,,21,10.5,,,,,,,,,,,,
97161 PHYS THER EVL LO CMP 20M,8102092,CDM,97161,CPT,Facility,both,,,,394,197,,,,,,,,,,,,
97162 PHYS THER EVL MD CMP 30M,8102093,CDM,97162,CPT,Facility,both,,,,304,152,,,,,,,,,,,,
97163 PHYS THER EVL HI CMP 45M,8102094,CDM,97163,CPT,Facility,both,,,,322,161,,,,,,,,,,,,
97164 PHYS THER REEVL ESTPLNCR,8102095,CDM,97164,CPT,Facility,both,,,,322,161,,,,,,,,,,,,
HOSP PFT SCRN REV&INT 94010,8140701,CDM,94010,CPT,Facility,both,,,,32.36,16.18,,,,,,,,,,,,
HOSP PFT AP REV & REPORT 94060,8140702,CDM,94060,CPT,Facility,both,,,,40.56,20.28,,,,,,,,,,,,
HOSP PFT DLCO REV & INTRP94729,8140703,CDM,94729,CPT,Facility,outpatient,,,,35.16,17.58,,,,,,,,,,,,
Hemorrhdctmy int bnd lig 46221,8174912,CDM,46221,CPT,Facility,inpatient,,,,640,320,,,,,,,,,,,,
Spirometry Pre+Post Bronchdltr,8198925,CDM,94010,CPT,Facility,both,,,,427.77,213.89,,,,,,,,,,,,
AC Aid Post Cruciate Lig 29889,8318895,CDM,29889,CPT,Facility,both,,,,117,58.5,,,,,,,,,,,,
Arthrscpy Ankl Prt Synov 29895,8334893,CDM,29895,CPT,Facility,both,,,,23,11.5,,,,,,,,,,,,
Clsd Tx Art Fx MPJ IPJ 26742,8392952,CDM,26742,CPT,Facility,both,,,,1327,663.5,,,,,,,,,,,,
Diffusing Capacity DLCO 94729,8468918,CDM,94729,CPT,Facility,both,,,,35.16,17.58,,,,,,,,,,,,
InjAnAgt/Strd PlnrDgtNrv 64455,8578979,CDM,64455,CPT,Facility,both,,,,133.6,66.8,,,,,,,,,,,,
Crit Cr Neo<= 28 days In 99468,8604953,CDM,99468,CPT,Facility,both,,,,3569.4,1784.7,,,,,,,,,,,,
Crit Cr Nen< = 28 dys Sb 99469,8604954,CDM,99469,CPT,Facility,both,,,,1546.2,773.1,,,,,,,,,,,,
Fx Nasl Infr Trbnat ther 30930,8736921,CDM,30930,CPT,Facility,both,,,,322,161,,,,,,,,,,,,
Arthroscopy WristDxW/woBx29840,8776944,CDM,29840,CPT,Facility,both,,,,140,70,,,,,,,,,,,,
Arthroscopy Ankle Rm L/FB29894,8776948,CDM,29894,CPT,Facility,both,,,,23,11.5,,,,,,,,,,,,
Drain Ext Audt Canal Les 69020,8796947,CDM,69020,CPT,Facility,both,,,,560.44,280.22,,,,,,,,,,,,
Cntrl Nsbld Pst AnyMth In30905,8796954,CDM,30905,CPT,Facility,both,,,,322,161,,,,,,,,,,,,
Cntrl Nsbld Pst AnyMth sb30905,8796955,CDM,30905,CPT,Facility,both,,,,322,161,,,,,,,,,,,,
Arthroscopy Elbw w/LtdDbr29837,8836933,CDM,29837,CPT,Facility,both,,,,140,70,,,,,,,,,,,,
Insert Cath Pleur w/Imag 32557,8888921,CDM,32557,CPT,Facility,both,,,,322,161,,,,,,,,,,,,
Arthro Knee w/Mnscs RM+A 29883,9048926,CDM,29883,CPT,Facility,both,,,,117,58.5,,,,,,,,,,,,
NP WndThr w/DisEq<=50SqCm97607,9054920,CDM,97607,CPT,Facility,both,,,,1412,706,,,,,,,,,,,,
Apply Long Leg Cast Brce 29358,9070932,CDM,29358,CPT,Facility,both,,,,397.84,198.92,,,,,,,,,,,,
Apply Short Leg Cast W/A 29425,9070933,CDM,29425,CPT,Facility,both,,,,318,159,,,,,,,,,,,,
Closed Tx Ulnar Fx Prox 24675,9070936,CDM,24675,CPT,Facility,inpatient,,,,1658.84,829.42,,,,,,,,,,,,
Cld Tx Ulnr Shft Fx w/oM 25535,9070937,CDM,25535,CPT,Facility,both,,,,1801.48,900.74,,,,,,,,,,,,
ClTx CarpalScaphd Fx w/o 25622,9070938,CDM,25622,CPT,Facility,both,,,,1117.96,558.98,,,,,,,,,,,,
ClTx CarpalScaphdFx w/m 25624,9070939,CDM,25624,CPT,Facility,both,,,,1751.36,875.68,,,,,,,,,,,,
Tx Clsd Elbow Dis w/o an 24600,9070942,CDM,24600,CPT,Facility,inpatient,,,,1477.68,738.84,,,,,,,,,,,,
Tx Tarsal Bone Fx w/M Ea 28455,9070943,CDM,28455,CPT,Facility,both,,,,1016.84,508.42,,,,,,,,,,,,
Fetal Bioph Prof w/o nst 76819,9162984,CDM,76819,CPT,Facility,both,,,,225,112.5,,,,,,,,,,,,
Bone Marrow Aspiratn Dx 38222,9179003,CDM,38222,CPT,Facility,inpatient,,,,113,56.5,,,,,,,,,,,,
PatientFc HlthRAs w/S&D 96160,9287062,CDM,96160,CPT,Facility,both,,,,10.28,5.14,,,,,,,,,,,,
Open Tx Navicular Fx 25628,9374920,CDM,25628,CPT,Facility,both,,,,2821.92,1410.96,,,,,,,,,,,,
Splenectomy Total (SP) 38100,9378950,CDM,38100,CPT,Facility,inpatient,,,,118,59,,,,,,,,,,,,
Skn Sub Grft TAL EA 25CM 15272,9446944,CDM,15272,CPT,Facility,both,,,,845,422.5,,,,,,,,,,,,
Flu Vax Admin 90471/ G0008,9456961,CDM,G0008,HCPCS,Facility,both,,,,81.74,40.87,,,,,,,,,,,,
Pneumo Vax Admin 90471 / G0009,9456962,CDM,G0009,HCPCS,Facility,both,,,,81.74,40.87,,,,,,,,,,,,
ClTx Foot Jnt Disl w/oAn 28600,9632919,CDM,28600,CPT,Facility,both,,,,741,370.5,,,,,,,,,,,,
Rp Lac <2.5cm M  A2/3Tng 41250,9772933,CDM,41250,CPT,Facility,both,,,,726,363,,,,,,,,,,,,
Rp Lac <2.5cm M  P1/3Tng 41250,9796924,CDM,41250,CPT,Facility,both,,,,726,363,,,,,,,,,,,,
Exc Lesn Floor of Mouth 41116,9820946,CDM,41116,CPT,Facility,both,,,,1054,527,,,,,,,,,,,,
Prostate Ca Scrn DigRtlExG0102,9874974,CDM,G0102,HCPCS,Facility,both,,,,35.04,17.52,,,,,,,,,,,,
Exc t Face Sclp SC >=2cm 21012,9986920,CDM,21012,CPT,Facility,inpatient,,,,1539,769.5,,,,,,,,,,,,
CT ELBOW LT WO/W,10066299,CDM,73202,CPT,Facility,outpatient,,,,1678,839,,,,,,,,,,,,
CT ELBOW LT W/,10066346,CDM,73201,CPT,Facility,outpatient,,,,1454,727,,,,,,,,,,,,
CT ELBOW LT WO CON,10066347,CDM,73200,CPT,Facility,outpatient,,,,1381,690.5,,,,,,,,,,,,
Splenorrhaphy w/wo Part 38115,10148922,CDM,38115,CPT,Facility,inpatient,,,,118,59,,,,,,,,,,,,
Drn Lymph Nod Abscss Smp 38300,10211078,CDM,38300,CPT,Facility,inpatient,,,,11.4,5.7,,,,,,,,,,,,
Drn Lm Nd Ab/Lmphdnts Ext38305,10211079,CDM,38305,CPT,Facility,inpatient,,,,1938.56,969.28,,,,,,,,,,,,
PERCUT ALLERGY SKIN TSTS 95004,10225030,CDM,95004,CPT,Facility,both,,,,15.36,7.68,,,,,,,,,,,,
Tracheostomy Planned SP 31600,10230955,CDM,31600,CPT,Facility,both,,,,1198.28,599.14,,,,,,,,,,,,
G0008 Medicare flu vax admin,10230973,CDM,g0008,HCPCS,Facility,both,,,,81.74,40.87,,,,,,,,,,,,
G0009 Mdcr pneumonia vax admin,10230985,CDM,g0009,HCPCS,Facility,both,,,,81.74,40.87,,,,,,,,,,,,
Cl tx Lunate Discl w/mn 25690,10232956,CDM,25690,CPT,Facility,both,,,,2027,1013.5,,,,,,,,,,,,
Revasc Endovasc Artry Ea 37232,10236925,CDM,37232,CPT,Facility,inpatient,,,,118,59,,,,,,,,,,,,
ELECTROCARDIOGRAM TRACING FAC,10239045,CDM,93005,CPT,Facility,both,,,,284.25,142.13,,,,,,,,,,,,
CpxRp Sc/a/leg 1.1-2.5cm 13120,10239177,CDM,13120,CPT,Facility,outpatient,,,,1090,545,,,,,,,,,,,,
Dr/dbrd PrtThck Brn 5-10 16025,10239178,CDM,16025,CPT,Facility,outpatient,,,,505,252.5,,,,,,,,,,,,
CldTreat Finger Fx w/o m 26740,10239183,CDM,26740,CPT,Facility,both,,,,866.44,433.22,,,,,,,,,,,,
Strapping Elbow/wrist 29260,10239192,CDM,29260,CPT,Facility,both,,,,54,27,,,,,,,,,,,,
Strapping Knee 29530,10239193,CDM,29530,CPT,Facility,both,,,,173,86.5,,,,,,,,,,,,
Strapping Toes 29550,10239194,CDM,29550,CPT,Facility,both,,,,99,49.5,,,,,,,,,,,,
Drainage of Gum Lesion 41800,10239203,CDM,41800,CPT,Facility,both,,,,592.84,296.42,,,,,,,,,,,,
Lumbar Puncture Tx Drn 62272,10239207,CDM,62272,CPT,Facility,inpatient,,,,347.72,173.86,,,,,,,,,,,,
G0010 Medicare Hep B vax admin,10242997,CDM,g0010,HCPCS,Facility,both,,,,81.74,40.87,,,,,,,,,,,,
Cld Tx Strnclvclr Ds wo m23520,10250932,CDM,23520,CPT,Facility,inpatient,,,,998,499,,,,,,,,,,,,
Clsd Tx Strnclvclr Ds w/m23525,10250933,CDM,23525,CPT,Facility,inpatient,,,,1563,781.5,,,,,,,,,,,,
Cld Tx Shldr Bld Fx w/m 23575,10250934,CDM,23575,CPT,Facility,inpatient,,,,2208,1104,,,,,,,,,,,,
ClTx Humeral Epcndlr w/o 24560,10250935,CDM,24560,CPT,Facility,inpatient,,,,1192,596,,,,,,,,,,,,
ClTx Humeral Cndlr Fx w/o24576,10250936,CDM,24576,CPT,Facility,inpatient,,,,1194,597,,,,,,,,,,,,
ClTx Humeral CndlrFx w/M24577,10250937,CDM,24577,CPT,Facility,inpatient,,,,3656,1828,,,,,,,,,,,,
ClsdTx Radl Hd/nck Fx w/m24655,10250938,CDM,24655,CPT,Facility,inpatient,,,,1603,801.5,,,,,,,,,,,,
ClTx Carpal Fx w/M ea 25635,10250939,CDM,25635,CPT,Facility,both,,,,1527,763.5,,,,,,,,,,,,
ClTx Femoral Fx Prxml W/M27232,10250941,CDM,27232,CPT,Facility,inpatient,,,,3190,1595,,,,,,,,,,,,
ClTx FemoralFx I/p/s W/oM27238,10250942,CDM,27238,CPT,Facility,inpatient,,,,1712,856,,,,,,,,,,,,
ClTx FemoralFx I/p/s W/M 27240,10250943,CDM,27240,CPT,Facility,inpatient,,,,3512,1756,,,,,,,,,,,,
ClTx Femoral Fx Su/t W/M 27503,10250944,CDM,27503,CPT,Facility,inpatient,,,,3708,1854,,,,,,,,,,,,
ClTx FemoralFxDstlCndlW/M27510,10250946,CDM,27510,CPT,Facility,inpatient,,,,3268,1634,,,,,,,,,,,,
Cltx Post Mall Fx w/man  27768,10250948,CDM,27768,CPT,Facility,inpatient,,,,1862,931,,,,,,,,,,,,
Closed Tx Fibula Fx w/m 27781,10250949,CDM,27781,CPT,Facility,inpatient,,,,2665,1332.5,,,,,,,,,,,,
Cld Tx Talus Fx w/o man 28430,10250950,CDM,28430,CPT,Facility,both,,,,666,333,,,,,,,,,,,,
Clsd Tx Talus Fx w/man 28435,10250951,CDM,28435,CPT,Facility,both,,,,1576,788,,,,,,,,,,,,
ClTx Great Toe p/pFx W/M 28495,10250952,CDM,28495,CPT,Facility,both,,,,576,288,,,,,,,,,,,,
Closed Tx Sesamoid Fx 28530,10250953,CDM,28530,CPT,Facility,both,,,,417,208.5,,,,,,,,,,,,
ClTx Knuckl Dx 1 w/M w/a 26705,10261013,CDM,26705,CPT,Facility,both,,,,1333,666.5,,,,,,,,,,,,
Arthro Aidd Rep Lg Osteo 29892,10322981,CDM,29892,CPT,Facility,both,,,,117,58.5,,,,,,,,,,,,
FNA Bx w/o Im Gd Add Les 10004,10332965,CDM,10004,CPT,Facility,outpatient,,,,290,145,,,,,,,,,,,,
Dsplcmnt tx (Proetz type)30210,10343018,CDM,30210,CPT,Facility,both,,,,399.2,199.6,,,,,,,,,,,,
Exc Lesion Tendon Toe Ea 28092,10364920,CDM,28092,CPT,Facility,both,,,,1047.88,523.94,,,,,,,,,,,,
(TAP) Block Bilat By Inj 64488,10373080,CDM,64488,CPT,Facility,both,,,,272.32,136.16,,,,,,,,,,,,
Inj Ans Agnt Vagus Nerve 64408,10398993,CDM,64408,CPT,Facility,both,,,,175.4,87.7,,,,,,,,,,,,
Exc Tis Forarm W > = 3cm 25071,10462937,CDM,25071,CPT,Facility,inpatient,,,,1672,836,,,,,,,,,,,,
Percut Img Gd Fluid Coll 10030,10482945,CDM,10030,CPT,Facility,outpatient,,,,1180,590,,,,,,,,,,,,
Exc Lesn Tongue w/o Clsr 41110,10482949,CDM,41110,CPT,Facility,both,,,,610,305,,,,,,,,,,,,
Drain Skene's Gland 53060,10486949,CDM,53060,CPT,Facility,both,,,,779,389.5,,,,,,,,,,,,
THORA,10491102,CDM,99211,CPT,Facility,both,,,,89,44.5,,,,,,,,,,,,
Explore Postop H-T-I Abd 35840,10526918,CDM,35840,CPT,Facility,inpatient,,,,260,130,,,,,,,,,,,,
Arthrscpy Shldr w/ Sy Pt 29820,10573476,CDM,29820,CPT,Facility,both,,,,94,47,,,,,,,,,,,,
Inj AnsAgnt Pudendal Nrv 64430,10600998,CDM,64430,CPT,Facility,both,,,,212.56,106.28,,,,,,,,,,,,
AC Aided Tx Knee w Fix 29851,10600999,CDM,29851,CPT,Facility,both,,,,101,50.5,,,,,,,,,,,,
Group Psych nt MultiFamG 90853,10754929,CDM,90853,CPT,Facility,both,,,,123,61.5,,,,,,,,,,,,
Psych Crisis Ea Ad 30m 90840,10764919,CDM,90840,CPT,Facility,both,,,,120,60,,,,,,,,,,,,
97016-PHYS THER VASOPNEUM DEV,10774929,CDM,97016,CPT,Facility,both,,,,60,30,,,,,,,,,,,,
97016-OCC THER VASOPNEUMATIC D,10774930,CDM,97016,CPT,Facility,both,,,,60,30,,,,,,,,,,,,
Thorascopy Dx Lngw/oBxSP 32601,10796970,CDM,32601,CPT,Facility,both,,,,1195.32,597.66,,,,,,,,,,,,
Remove Indw-Tunn PleCath 32552,10806922,CDM,32552,CPT,Facility,both,,,,613.4,306.7,,,,,,,,,,,,
90912 BIFDBK TRN W/EMG 1st 15m,10823079,CDM,90912,CPT,Facility,both,,,,64,32,,,,,,,,,,,,
90912 BIOFEEDBACK TRAING W/EMG,10823080,CDM,90912,CPT,Facility,both,,,,64,32,,,,,,,,,,,,
90913 BIFDBK TRN W/EMG add 15m,10823081,CDM,90913,CPT,Facility,both,,,,54,27,,,,,,,,,,,,
90913 BIOFEEDBACK TRAING W/EMG,10823082,CDM,90913,CPT,Facility,both,,,,54,27,,,,,,,,,,,,
97129 THER IVN COG FUN 1st 15m,10823084,CDM,97129,CPT,Facility,both,,,,117,58.5,,,,,,,,,,,,
97129 THER IVNTJ COGNITIVE FUN,10823085,CDM,97129,CPT,Facility,both,,,,117,58.5,,,,,,,,,,,,
97130 THER IVNTJ COGFN add 15m,10823086,CDM,97130,CPT,Facility,both,,,,90,45,,,,,,,,,,,,
97130 THER IVNTJ COGNITIVE ST /add15 min,10823087,CDM,97130,CPT,Facility,both,,,,90,45,,,,,,,,,,,,
97139 DRY NEEDLING PROC PT,10829022,CDM,97139,CPT,Facility,both,,,,23,11.5,,,,,,,,,,,,
97139 DRY NEEDLING PROCEDURE O,10829023,CDM,97139,CPT,Facility,both,,,,23,11.5,,,,,,,,,,,,
ED Psych Crisis Int 60m 90839,10832922,CDM,90839,CPT,Facility,both,,,,241,120.5,,,,,,,,,,,,
ED  PsychCrisis EaAd30m 90840,10832924,CDM,90840,CPT,Facility,both,,,,120,60,,,,,,,,,,,,
ED Psychiatric Dx Eval 90791,10832925,CDM,90791,CPT,Facility,both,,,,241,120.5,,,,,,,,,,,,
ED Psych DxEval w/MedSrv 90792,10832926,CDM,90792,CPT,Facility,both,,,,320,160,,,,,,,,,,,,
Thoracotomy w/Card Massg 32160,10863037,CDM,32160,CPT,Facility,both,,,,3098.04,1549.02,,,,,,,,,,,,
Wound Vac Pump Charge/day,10878936,CDM,,,Facility,both,,,,219,109.5,,,,,,,,,,,,
ClsdTx Shoulder Dis w/fx 23675,10894930,CDM,23675,CPT,Facility,inpatient,,,,1970.52,985.26,,,,,,,,,,,,
Rem FB Foot SC Complct 28193,10898928,CDM,28193,CPT,Facility,both,,,,1789.32,894.66,,,,,,,,,,,,
Bx Forarm/Wrst Sft TissD 25066,10902922,CDM,25066,CPT,Facility,inpatient,,,,1432.48,716.24,,,,,,,,,,,,
98970 QUAL NONMD ONLINE 5-10M,10919121,CDM,98970,CPT,Facility,both,,,,11.4,5.7,,,,,,,,,,,,
Manipulate Elbow w/ Anes 24300,11022943,CDM,24300,CPT,Facility,inpatient,,,,1701.16,850.58,,,,,,,,,,,,
Laryngoscp Dir Op FB rem 31530,11056938,CDM,31530,CPT,Facility,both,,,,150,75,,,,,,,,,,,,
Recnst Lat Coll Lig Elbw 24344,11061008,CDM,24344,CPT,Facility,inpatient,,,,4280.24,2140.12,,,,,,,,,,,,
Arthroscopy Elbow w/ Rem 29834,11062933,CDM,29834,CPT,Facility,both,,,,140,70,,,,,,,,,,,,
Arthroscpy Elbw Debr Ext 29838,11062934,CDM,29838,CPT,Facility,both,,,,140,70,,,,,,,,,,,,
PlvUS (N Ob) RT w/ ImD Lm76857,11196965,CDM,76857,CPT,Facility,both,,,,270,135,,,,,,,,,,,,
ACARBOSE 25MG TABLET,25000010,CDM,J8499,HCPCS,Facility,outpatient,,,,1.53,0.77,,,,,,,,,,,,
LOESTRIN 21 1/20 TABLET,25000020,CDM,J8499,HCPCS,Facility,outpatient,,,,5,2.5,,,,,,,,,,,,
"Ringers Solution, Lactate 1,00",25000035,CDM, J7501,HCPCS,Facility,outpatient,,,,60,30,,,,,,,,,,,,
0.9% Sodium Chloride 100ml,25000040,CDM,J7030,HCPCS,Facility,outpatient,,,,24,12,,,,,,,,,,,,
"Total Parenteral Nutrition 1,0",25000045,CDM, B4150,HCPCS,Facility,outpatient,,,,15,7.5,,,,,,,,,,,,
Digoxin 50 MCG/ML Ampul,25000050,CDM,J2100,HCPCS,Facility,both,,,,22.5,11.25,,,,,,,,,,,,
Labetalol HCL 5 MG/ML VIAL,25000055,CDM,J2212,HCPCS,Facility,both,,,,49.5,24.75,,,,,,,,,,,,
Oxycodone/Acetaminophen 5/325,25000065,CDM, J7613,HCPCS,Facility,outpatient,,,,5,2.5,,,,,,,,,,,,
Oxycodone/Acetaminophen 10/325,25000070,CDM, J7613,HCPCS,Facility,outpatient,,,,36,18,,,,,,,,,,,,
Hydrocortisone 0.5% 28 Applic,25000075,CDM,J2326,HCPCS,Facility,both,,,,28,14,,,,,,,,,,,,
CefAZolin 1 GM Vial,25000085,CDM,J1370,HCPCS,Facility,outpatient,,,,105,52.5,,,,,,,,,,,,
Morphine Sulfate 10 MG/ML Vial,25000095,CDM, J2270,HCPCS,Facility,both,,,,23,11.5,,,,,,,,,,,,
"cefTRIAXone/D5W 1,000 MG/50 ML",25000100,CDM,J1430,HCPCS,Facility,outpatient,,,,110,55,,,,,,,,,,,,
insulin NPH/insulin reg 70/30,25000125,CDM,J2356,HCPCS,Facility,both,,,,11.25,5.63,,,,,,,,,,,,
Insulin Regular Human 100 Unit,25000130,CDM,J2357,HCPCS,Facility,both,,,,15,7.5,,,,,,,,,,,,
fentaNYL 25mcg/hr Patch,25000150,CDM,J2248,HCPCS,Facility,both,,,,34.5,17.25,,,,,,,,,,,,
HYDROmorphone/NS 20 MG/100 ML,25000155,CDM,J2332,HCPCS,Facility,both,,,,15.25,7.63,,,,,,,,,,,,
DEXLANSOPRAZOLE 30 MG Capsule,25000165,CDM,J1840,HCPCS,Facility,outpatient,,,,5,2.5,,,,,,,,,,,,
FLUCELVAX QUAD 2021-2022 SYR,25000170,CDM,J2259,HCPCS,Facility,both,,,,10,5,,,,,,,,,,,,
Tangential biopsy of skin,25000171,CDM,11102,CPT,Facility,outpatient,,,,238,119,,,,,,,,,,,,
Punch biopsy of skin,25000172,CDM,11104,CPT,Facility,outpatient,,,,480,240,,,,,,,,,,,,
Incisional biopsy of skin ,25000173,CDM,11105,CPT,Facility,outpatient,,,,132.25,66.13,,,,,,,,,,,,
"Fine needle aspiration biopsy, ",25000174,CDM,10022,CPT,Facility,outpatient,,,,172.48,86.24,,,,,,,,,,,,
Kenalog 40mg Injection,25000175,CDM,J3301,HCPCS,Facility,both,,,,44.1,22.05,,,,,,,,,,,,
Doxorubicin,25000180,CDM,J2350,HCPCS,Facility,both,,,,3,1.5,,,,,,,,,,,,
VENIPUNCTURE,30001000,CDM,36415,CPT,Facility,both,,,,27,13.5,,,,,,,,,,,,
Hematocrit,30500020,CDM,85014,CPT,Facility,both,,,,43,21.5,,,,,,,,,,,,
IV INFUSION CONCURRENT,37000016,CDM,96368,CPT,Facility,both,,,,205,102.5,,,,,,,,,,,,
ER LEVEL 1 EVAL,45000010,CDM,99281,CPT,Facility,both,,,,222.24,111.12,,,,,,,,,,,,
ER LEVEL 2 EVAL,45000015,CDM,99282,CPT,Facility,both,,,,402.45,201.23,,,,,,,,,,,,
ER LEVEL 3 EVAL,45000020,CDM,99283,CPT,Facility,both,,,,709.05,354.53,,,,,,,,,,,,
ER LEVEL 4 EVAL,45000025,CDM,99284,CPT,Facility,both,,,,1114.56,557.28,,,,,,,,,,,,
ER LEVEL 5 EVAL,45000030,CDM,99285,CPT,Facility,both,,,,1599.81,799.91,,,,,,,,,,,,
HEPARIN SNG  5000U,63600015,CDM,J2313,HCPCS,Facility,both,,,,15.25,7.63,,,,,,,,,,,,
Observation Per Hour,76200010,CDM,,,Facility,both,,,,152,76,,,,,,,,,,,,
Drug Administration (Vaccine),77100010,CDM,90471,CPT,Facility,both,,,,126.64,63.32,,,,,,,,,,,,
Initial Hospital Care Level 1,98703010,CDM,99221,CPT,Facility,both,,,,389.8,194.9,,,,,,,,,,,,
Initial Hospital Care Level 2,98703020,CDM,99221,CPT,Facility,both,,,,389.8,194.9,,,,,,,,,,,,
Inital Hospital Care Level 3,98703030,CDM,99223,CPT,Facility,both,,,,770.16,385.08,,,,,,,,,,,,
Sub. Hospital Care Level 1,98704010,CDM,99231,CPT,Facility,both,,,,150.4,75.2,,,,,,,,,,,,
Sub Hospital Care Level 2,98704020,CDM,99232,CPT,Facility,both,,,,276.96,138.48,,,,,,,,,,,,
Sub Hospital Care Level 3,98704030,CDM,99233,CPT,Facility,both,,,,398.04,199.02,,,,,,,,,,,,
PRIVATE ROOM,101030,CDM,,,Facility,both,,,,2949,1474.5,,,,,,,,,,,,
SKILLED BED,201004,CDM,,,Facility,both,,,,2949,1474.5,,,,,,,,,,,,
FINGER RT 3RD DIGIT MIN 2 VIEW,2001131,CDM,73140,CPT,Facility,both,,,,242,121,,,,,,,,,,,,
FINGER RT 5TH DIGIT MIN 2 VIEW,2001133,CDM,73140,CPT,Facility,both,,,,242,121,,,,,,,,,,,,
TOE LT 3RD,2001135,CDM,73660,CPT,Facility,both,,,,229,114.5,,,,,,,,,,,,
TOE LT 5TH,2001137,CDM,73660,CPT,Facility,both,,,,229,114.5,,,,,,,,,,,,
FINGER RT 2ND DIGIT MIN 2 VIEW,2001139,CDM,73140,CPT,Facility,both,,,,242,121,,,,,,,,,,,,
TOE RT 2ND,2001141,CDM,73660,CPT,Facility,both,,,,229,114.5,,,,,,,,,,,,
TOE RT 4TH,2001143,CDM,73660,CPT,Facility,both,,,,229,114.5,,,,,,,,,,,,
MANDIBLE-LIMITED,2001145,CDM,70100,CPT,Facility,both,,,,388,194,,,,,,,,,,,,
SPINE LUMBAR COMP W/BEND,2001147,CDM,72114,CPT,Facility,both,,,,655,327.5,,,,,,,,,,,,
Bx/Ex LmphNds OpDp Axill 38525,2726867,CDM,38525,CPT,Facility,both,,,,1729.32,864.66,,,,,,,,,,,,
Inj Radctv Trcr IDSntlNd 38792,2726875,CDM,38792,CPT,Facility,both,,,,321.12,160.56,,,,,,,,,,,,
MONO TEST,3001034,CDM,86308,CPT,Facility,both,,,,20.72,10.36,,,,,,,,,,,,
SPLINT THUMB SPICA RT LG,5500069,CDM,,,Facility,both,,,,14,7,,,,,,,,,,,,
ENDOT ADULT CAPNOL TUB,5500137,CDM,,,Facility,both,,,,22.95,11.48,,,,,,,,,,,,
EYEPATCH,5501129,CDM,,,Facility,both,,,,1,0.5,,,,,,,,,,,,
CIRCUIT VENT W/OUT PEEP PED,5501318,CDM,,,Facility,both,,,,30,15,,,,,,,,,,,,
SUTURE 4-0 SILK OPHTH,5501325,CDM,,,Facility,both,,,,115,57.5,,,,,,,,,,,,
CAUTERY HAND PENCIL,5501393,CDM,,,Facility,both,,,,31,15.5,,,,,,,,,,,,
E-VAC CONTAINER,5501429,CDM,,,Facility,both,,,,125,62.5,,,,,,,,,,,,
HUMIDIFIER O2 SM <299,5501479,CDM,,,Facility,both,,,,15,7.5,,,,,,,,,,,,
STERILE WATER IRRIG 1000 ML,5501533,CDM,,,Facility,both,,,,26.75,13.38,,,,,,,,,,,,
"BANDAGE GAUZE ROLL 2""",5501539,CDM,,,Facility,both,,,,3,1.5,,,,,,,,,,,,
STOCKINGS PO KNEE,5501644,CDM,,,Facility,both,,,,47,23.5,,,,,,,,,,,,
SYRINGES 60 CC,5501683,CDM,,,Facility,both,,,,7,3.5,,,,,,,,,,,,
WRIST ELASTIC BRACE UNIVERSAL,5501712,CDM,,,Facility,both,,,,5,2.5,,,,,,,,,,,,
GAUZE XEROFORM,5501714,CDM,,,Facility,both,,,,15,7.5,,,,,,,,,,,,
SYRINGE 30CC,5501743,CDM,,,Facility,both,,,,5,2.5,,,,,,,,,,,,
URINAL W/COVER,5501748,CDM,,,Facility,both,,,,39.95,19.98,,,,,,,,,,,,
STOCK ANTI EMB KNEE HI LG,5501764,CDM,,,Facility,both,,,,73,36.5,,,,,,,,,,,,
ARMBOARD BENDABLE LG,5501770,CDM,,,Facility,both,,,,10,5,,,,,,,,,,,,
BETADINE SWABSTICK 1 EACH PKG,5501784,CDM,,,Facility,both,,,,1,0.5,,,,,,,,,,,,
MASK CPR CHILD,5501848,CDM,,,Facility,both,,,,58,24,,,,,,,,,,,,
FOLEY TRAY I C,5501872,CDM,,,Facility,both,,,,35,17.5,,,,,,,,,,,,
SURGICAL BLADE # 11,5501981,CDM,,,Facility,both,,,,5,2.5,,,,,,,,,,,,
TRANSPARENT DRESSING  8X10,5502106,CDM,,,Facility,both,,,,10,5,,,,,,,,,,,,
TUBULAR GAUZE,5502109,CDM,,,Facility,both,,,,10,5,,,,,,,,,,,,
ANKLE BRACE MEDIUM,5502173,CDM,,,Facility,both,,,,35,17.5,,,,,,,,,,,,
AIRWAY INNER CANNULA SZ B,5502198,CDM,,,Facility,both,,,,25,12.5,,,,,,,,,,,,
"PACKING PLAIN 1""",5502284,CDM,,,Facility,both,,,,26,13,,,,,,,,,,,,
"PACKING-IODOFORM 1/4""",5502287,CDM,,,Facility,both,,,,25,12.5,,,,,,,,,,,,
ARM SLING XLG,5502395,CDM,,,Facility,both,,,,25,12.5,,,,,,,,,,,,
DEFIBRILATOR PADS 4 1/2 X 9,5502478,CDM,,,Facility,both,,,,150,75,,,,,,,,,,,,
DRESS TRANSPARENT 4 X 4 3/4,5502489,CDM,,,Facility,both,,,,6,3,,,,,,,,,,,,
IV START KIT W/TEGADERM DRESS,5502515,CDM,,,Facility,both,,,,6,3,,,,,,,,,,,,
O2 EVA FLEX TUBING 6' CORR,5502526,CDM,,,Facility,both,,,,30,15,,,,,,,,,,,,
O2 TUBING 7' VINYL TIPPED,5502533,CDM,,,Facility,both,,,,40,20,,,,,,,,,,,,
TUBE FEEDING ATT DEVICE 5-18FR,5502611,CDM,,,Facility,both,,,,65.55,32.78,,,,,,,,,,,,
SPLINT TIBIA,5502702,CDM,,,Facility,both,,,,202,101,,,,,,,,,,,,
ARM SLING SMALL,5502723,CDM,,,Facility,both,,,,35,17.5,,,,,,,,,,,,
ARM SLING MEDIUM,5502724,CDM,,,Facility,both,,,,35,17.5,,,,,,,,,,,,
ARM SLING LARGE,5502725,CDM,,,Facility,both,,,,35,17.5,,,,,,,,,,,,
SUCTION CATH KIT 8FR,5502731,CDM,,,Facility,both,,,,6,3,,,,,,,,,,,,
TRAY FOLEY CATH 16FR 5CC,5502837,CDM,,,Facility,both,,,,30,15,,,,,,,,,,,,
PADDING CAST 3X4 SOF-ROL,5502852,CDM,,,Facility,both,,,,10,5,,,,,,,,,,,,
FOLEY CATH 16FR 2 WAY,5502868,CDM,,,Facility,both,,,,30,15,,,,,,,,,,,,
ET TUBE HOLDER,5502875,CDM,,,Facility,both,,,,27,13.5,,,,,,,,,,,,
CIRCUIT  VENT W/OUT PEEP ADULT,5502933,CDM,,,Facility,both,,,,30,15,,,,,,,,,,,,
BETADINE IODINE 8 OZ,5502977,CDM,,,Facility,both,,,,10,5,,,,,,,,,,,,
FLEET ENEMA,5503092,CDM,,,Facility,both,,,,3,1.5,,,,,,,,,,,,
WRIST SUPPORT RT MED,5503221,CDM,,,Facility,both,,,,168,84,,,,,,,,,,,,
MASK NEBULIZER ADULT,5503233,CDM,,,Facility,both,,,,39,19.5,,,,,,,,,,,,
OPTIFLEX KIT,5503235,CDM,,,Facility,both,,,,164,82,,,,,,,,,,,,
BREATHING CIRCUIT ADULT RE,5503241,CDM,,,Facility,both,,,,23,11.5,,,,,,,,,,,,
SUTURE 5-0 ETHILON 661,5510005,CDM,,,Facility,both,,,,120,60,,,,,,,,,,,,
AEROSOL MASK PED,5510006,CDM,,,Facility,both,,,,6,3,,,,,,,,,,,,
MASK BIPAP/CPAP NASAL LG,5510035,CDM,,,Facility,both,,,,116.81,58.41,,,,,,,,,,,,
ENDOTRACH TUBE 6.5MM,5510087,CDM,,,Facility,both,,,,13,6.5,,,,,,,,,,,,
ICE PACK INSTANT COLD,5510109,CDM,,,Facility,both,,,,12,6,,,,,,,,,,,,
STYLET INTUBATING DISP 10 FR.,5510225,CDM,,,Facility,both,,,,200,100,,,,,,,,,,,,
SUTURE 3-0 ETHILON 663H,5510253,CDM,,,Facility,both,,,,130,65,,,,,,,,,,,,
SUTURE 0 VICRYL J603H,5510269,CDM,,,Facility,both,,,,120,60,,,,,,,,,,,,
SUTURE 3-0 VICRYL J416H,5510281,CDM,,,Facility,both,,,,120,60,,,,,,,,,,,,
PEAK FLOW METER,5510748,CDM,,,Facility,both,,,,50,25,,,,,,,,,,,,
Border gauze dressing 2 x 2,5520001,CDM,,,Facility,both,,,,1,0.5,,,,,,,,,,,,
ER- CRIT CARE ADDT'L 30 MIN,6000015,CDM,99292,CPT,Facility,both,,,,36.6,18.3,,,,,,,,,,,,
SPECIAL CONSULTATION - LEVEL 2,7500371,CDM,99222,CPT,Facility,both,,,,524.96,262.48,,,,,,,,,,,,
SPECIAL CONSULTATION - LEVEL 3,7500372,CDM,99223,CPT,Facility,both,,,,770.16,385.08,,,,,,,,,,,,
OBS INITIAL LEVEL 2 PER DAY,7501161,CDM,99219,CPT,Facility,both,,,,514.88,257.44,,,,,,,,,,,,
PULM Rehab Spacer,7819231,CDM,,,Facility,both,,,,58,29,,,,,,,,,,,,
AMB Dtap-IPV-Hib/Pentacel SS,7877454,CDM,,,Facility,both,,,,274.22,137.11,,,,,,,,,,,,
RT Supplies Steril H20 Inhalng,7882316,CDM,,,Facility,both,,,,32,16,,,,,,,,,,,,
RT Supplies  Rebreather mask,7882319,CDM,,,Facility,both,,,,32,16,,,,,,,,,,,,
RT Suppl Min Heart Flw W/AdMsk,7882322,CDM,,,Facility,both,,,,44,22,,,,,,,,,,,,
RT Supplies  H20 Traps,7882325,CDM,,,Facility,both,,,,32,16,,,,,,,,,,,,
OCC THER AFO MOLD PT CUSTOM,8010169,CDM,,,Facility,both,,,,237,118.5,,,,,,,,,,,,
OCC THER ANKLE BRACE,8010170,CDM,,,Facility,both,,,,178,89,,,,,,,,,,,,
OCC THER ARTIFLX 15CM BANDAGE,8010186,CDM,,,Facility,both,,,,33,16.5,,,,,,,,,,,,
OCC THER BIOFREEZE 16OZ,8010187,CDM,,,Facility,both,,,,81,40.5,,,,,,,,,,,,
OCC THER BIOFREEZE 4OZ,8010188,CDM,,,Facility,both,,,,30,15,,,,,,,,,,,,
OCC THER CLAVICULAR STRAP,8010195,CDM,,,Facility,both,,,,220,110,,,,,,,,,,,,
OCC THER COMPRESION BANDGE 8CM,8010199,CDM,,,Facility,both,,,,46,23,,,,,,,,,,,,
OCC THER COMPRESN BANDAGE 10CM,8010200,CDM,,,Facility,both,,,,54,27,,,,,,,,,,,,
OCC THER COMPRESSN BANDAGE 8CM,8010201,CDM,,,Facility,both,,,,42,21,,,,,,,,,,,,
OCC THER COMPRSION BANDAGE 12C,8010206,CDM,,,Facility,both,,,,114,57,,,,,,,,,,,,
OCC THER EO - PREFAB ELASTIC,8010210,CDM,,,Facility,both,,,,80,40,,,,,,,,,,,,
OCC THER EO DYN ELBOW ONLY,8010211,CDM,,,Facility,both,,,,405,202.5,,,,,,,,,,,,
OCC THER EO ELB POST/ANT SHELL,8010212,CDM,,,Facility,both,,,,1007,503.5,,,,,,,,,,,,
OCC THER EWHFO DYN ELB W/WRIST,8010217,CDM,,,Facility,both,,,,621,310.5,,,,,,,,,,,,
OCC THER EWHFO STAT ELB W/THMB,8010218,CDM,,,Facility,both,,,,3425,1712.5,,,,,,,,,,,,
OCC THER EWHO DYN HINGED ELBOW,8010219,CDM,,,Facility,both,,,,4926,2463,,,,,,,,,,,,
OCC THER EWHO S ELB/WRIST HAND,8010220,CDM,,,Facility,both,,,,1399,699.5,,,,,,,,,,,,
OCC THER FO DYN FINGER DYN NEO,8010221,CDM,,,Facility,both,,,,363,181.5,,,,,,,,,,,,
OCC THER FOOT INSERT/UCB TYPE,8010222,CDM,,,Facility,both,,,,1662,831,,,,,,,,,,,,
OCC THER FORE/UPPER ARM SPLINT,8010223,CDM,,,Facility,both,,,,708,354,,,,,,,,,,,,
OCC THER HAND HELPER R BAND,8010225,CDM,,,Facility,both,,,,30,15,,,,,,,,,,,,
L3913-OCC THER HAND/FING ORTHO,8010226,CDM,,,Facility,both,,,,291,145.5,,,,,,,,,,,,
OCC THER HEELBO PROTECTORS,8010227,CDM,,,Facility,both,,,,41,20.5,,,,,,,,,,,,
L3921-OCC THER HFO DYN TH/DIGI,8010228,CDM,,,Facility,both,,,,708,354,,,,,,,,,,,,
OCC THER HFO STATIC MC/DIGITS,8010229,CDM,,,Facility,both,,,,194,97,,,,,,,,,,,,
OCC THER HO STAT MC FX BRACE,8010230,CDM,,,Facility,both,,,,874,437,,,,,,,,,,,,
OCC THER HO STATIC MC FX BRACE,8010231,CDM,,,Facility,both,,,,531,265.5,,,,,,,,,,,,
OCC THER ISOBAND 15cm X 5m,8010234,CDM,,,Facility,both,,,,38,19,,,,,,,,,,,,
OCC THER ISOBAND 20cm X 5m,8010235,CDM,,,Facility,both,,,,50,25,,,,,,,,,,,,
OCC THER ISOTONER GLOVES,8010236,CDM,,,Facility,both,,,,57,28.5,,,,,,,,,,,,
OCC THER KNEE ORTHOSIS PREFAB,8010237,CDM,,,Facility,both,,,,91,45.5,,,,,,,,,,,,
OCC THER LEG LIFTER,8010238,CDM,,,Facility,both,,,,48,24,,,,,,,,,,,,
OCC THER NECKROLL,8010247,CDM,,,Facility,both,,,,49,24.5,,,,,,,,,,,,
OCC THER ORTHO SOFT INSERT,8010252,CDM,,,Facility,both,,,,264,132,,,,,,,,,,,,
OCC THER PATELLOFEMORAL SLEEVE,8010259,CDM,,,Facility,both,,,,79,39.5,,,,,,,,,,,,
OCC THER PREFAB FNG EXT SPLINT,8010261,CDM,,,Facility,both,,,,226,113,,,,,,,,,,,,
OCC THER PREFAB WHFO W JNTS,8010262,CDM,,,Facility,both,,,,59,29.5,,,,,,,,,,,,
OCC THER PREFAB WHFO WO JNTS,8010263,CDM,,,Facility,both,,,,85,42.5,,,,,,,,,,,,
OCC THER REACHER FEATHERWEIGHT,8010268,CDM,,,Facility,both,,,,220,110,,,,,,,,,,,,
OCC THER SEWHO STATIC CUSTOM,8010274,CDM,,,Facility,both,,,,51,25.5,,,,,,,,,,,,
OCC THER SHOULDER PULLEY,8010275,CDM,,,Facility,both,,,,61,30.5,,,,,,,,,,,,
OCC THER SO AIRPLNE W OR WO JT,8010276,CDM,,,Facility,both,,,,540,270,,,,,,,,,,,,
OCC THER SO STATIC SHOULD/HUME,8010277,CDM,,,Facility,both,,,,101,50.5,,,,,,,,,,,,
OCC THER SOCK AID,8010278,CDM,,,Facility,both,,,,39,19.5,,,,,,,,,,,,
OCC THER STATIC FINGER CUSTOM,8010280,CDM,,,Facility,both,,,,316,158,,,,,,,,,,,,
L3906-OCC THER STATIC WRIST,8010282,CDM,,,Facility,both,,,,141,70.5,,,,,,,,,,,,
OCC THER TAPE SUPPLY,8010288,CDM,,,Facility,both,,,,57,28.5,,,,,,,,,,,,
OCC THER THUMB VOLAR/DORSAL DY,8010295,CDM,,,Facility,both,,,,73,36.5,,,,,,,,,,,,
OCC THER TUBULAR BANDAGE 6CM,8010298,CDM,,,Facility,both,,,,114,57,,,,,,,,,,,,
OCC THER TUBULAR BANDAGE 8CM,8010299,CDM,,,Facility,both,,,,124,62,,,,,,,,,,,,
OCC THER ULNAR GUTTER MPS FRE,8010301,CDM,,,Facility,both,,,,679,339.5,,,,,,,,,,,,
L3808-OCC THER WHFO - PREFAB W,8010304,CDM,,,Facility,both,,,,63,31.5,,,,,,,,,,,,
OCC THER WHFO 1+ NONTORSION JT,8010305,CDM,,,Facility,both,,,,862,431,,,,,,,,,,,,
OCC THER WHFO DYN HINGED WRIST,8010306,CDM,,,Facility,both,,,,2395,1197.5,,,,,,,,,,,,
OCC THER WHFO DYN REC/DUAL ACT,8010307,CDM,,,Facility,both,,,,1486,743,,,,,,,,,,,,
L3808-OCC THER WHFO RIGID W/O,8010308,CDM,,,Facility,both,,,,95,47.5,,,,,,,,,,,,
L3908-OCC THER WHFO RIGID W/O,8010309,CDM,,,Facility,both,,,,302,151,,,,,,,,,,,,
OCC THER WRIST/THUMB NEOPRENE,8010310,CDM,,,Facility,both,,,,95,47.5,,,,,,,,,,,,
PHYS THER ANKLE FOOT ORTHOSIS,8010312,CDM,,,Facility,both,,,,115,57.5,,,,,,,,,,,,
PHYS THER BACKROLL,8010313,CDM,,,Facility,both,,,,41,20.5,,,,,,,,,,,,
PHYS THER BALANCE DISCS,8010314,CDM,,,Facility,both,,,,102,51,,,,,,,,,,,,
PHYS THER BIOFREEZE 16OZ,8010315,CDM,,,Facility,both,,,,81,40.5,,,,,,,,,,,,
PHYS THER BIOFREEZE 4OZ,8010316,CDM,,,Facility,both,,,,30,15,,,,,,,,,,,,
PHYS THER COMPRESSION STKGS,8010324,CDM,,,Facility,both,,,,116,58,,,,,,,,,,,,
PHYS THER CPM KNEE PADS,8010326,CDM,,,Facility,both,,,,72,36,,,,,,,,,,,,
PHYS THER CPM MACHINE/DAY,8010327,CDM,,,Facility,both,,,,72,36,,,,,,,,,,,,
PHYS THER CRUTCHES X2,8010328,CDM,,,Facility,both,,,,59,29.5,,,,,,,,,,,,
PHYS THER FOAM ROLLER 6X12,8010333,CDM,,,Facility,both,,,,46,23,,,,,,,,,,,,
PHYS THER FOAM ROLLER 6X36,8010334,CDM,,,Facility,both,,,,85,42.5,,,,,,,,,,,,
PHYS THER GYMBALL 45CM,8010336,CDM,,,Facility,both,,,,46,23,,,,,,,,,,,,
PHYS THER GYMBALL 55CM,8010337,CDM,,,Facility,both,,,,66,33,,,,,,,,,,,,
PHYS THER GYMBALL 65 CM,8010338,CDM,,,Facility,both,,,,83,41.5,,,,,,,,,,,,
PHYS THER HAND/FING ORTHOSIS,8010339,CDM,,,Facility,both,,,,291,145.5,,,,,,,,,,,,
PHYS THER ICE PICKS/PAIR,8010341,CDM,,,Facility,both,,,,57,28.5,,,,,,,,,,,,
PHYS THER JUZO COMPRESS SLEEVE,8010343,CDM,,,Facility,both,,,,140,70,,,,,,,,,,,,
PHYS THER JUZO STOCKINGS PAIR,8010344,CDM,,,Facility,both,,,,152,76,,,,,,,,,,,,
PHYS THER KNEE BRACE KNEE JNT,8010345,CDM,,,Facility,both,,,,140,70,,,,,,,,,,,,
PHYS THER LEG LIFTER,8010346,CDM,,,Facility,both,,,,48,24,,,,,,,,,,,,
PHYS THER LUMBOSACRAL BRACE,8010348,CDM,,,Facility,both,,,,82,41,,,,,,,,,,,,
PHYS THER MATERNITY SUPPORT,8010350,CDM,,,Facility,both,,,,59,29.5,,,,,,,,,,,,
PHYS THER MISC ORTHOTIC,8010352,CDM,,,Facility,both,,,,66,33,,,,,,,,,,,,
PHYS THER NECK ROLL,8010356,CDM,,,Facility,both,,,,49,24.5,,,,,,,,,,,,
PHYS THER NIGHT SPLINT,8010358,CDM,,,Facility,both,,,,210,105,,,,,,,,,,,,
PHYS THER SHOULDER PULLEY,8010380,CDM,,,Facility,both,,,,61,30.5,,,,,,,,,,,,
PHYS THER SI SUPPORT,8010381,CDM,,,Facility,both,,,,83,41.5,,,,,,,,,,,,
PHYS THER SILICONE HEEL CUP,8010382,CDM,,,Facility,both,,,,88,44,,,,,,,,,,,,
PHYS THER TAPE SUPPLY,8010390,CDM,,,Facility,both,,,,57,28.5,,,,,,,,,,,,
PHYS THER THERACANE,8010395,CDM,,,Facility,both,,,,140,70,,,,,,,,,,,,
PHYS THER WRIST HAND ORTHOTIC,8010404,CDM,,,Facility,both,,,,451,225.5,,,,,,,,,,,,
EMP CSR DRESSING CHANGE COMPLX,8127305,CDM,,,Facility,both,,,,63,31.5,,,,,,,,,,,,
EMP CSR DRESSING CHANGE POSTOP,8127306,CDM,,,Facility,both,,,,24,12,,,,,,,,,,,,
InOp IDSLmphNds w/InjDye 38900,9214918,CDM,38900,CPT,Facility,both,,,,539.96,269.98,,,,,,,,,,,,
All Inclusive Rate R&B,10000010,CDM,,,Facility,both,,,,1095,547.5,,,,,,,,,,,,
All Inclusive Rate R&B,10100010,CDM,,,Facility,both,,,,1095,547.5,,,,,,,,,,,,
Repair Lip Fll Thck Verm 40650,10239200,CDM,40650,CPT,Facility,both,,,,1214.88,607.44,,,,,,,,,,,,
Bx/Ex LpmhNds OpIngnfmrl 38531,10332982,CDM,38531,CPT,Facility,both,,,,1751,875.5,,,,,,,,,,,,
ED psych boarder daily charge,10795116,CDM,,,Facility,both,,,,1095,547.5,,,,,,,,,,,,
Private Room & Bed General,11000010,CDM,,,Facility,both,,,,2949,1474.5,,,,,,,,,,,,
Private Room - Nursing Home,11000015,CDM,,,Facility,both,,,,2949,1474.5,,,,,,,,,,,,
Private Room - Assisted Living,11000020,CDM,,,Facility,both,,,,2949,1474.5,,,,,,,,,,,,
Private Room MedSurg 2N,11100010,CDM,,,Facility,both,,,,2949,1474.5,,,,,,,,,,,,
Private Room MedSurg 1W,11100015,CDM,,,Facility,both,,,,2949,1474.5,,,,,,,,,,,,
COVID Vax Moderna 2ndD w/Ad SS,11258942,CDM,0012A,HCPCS,Facility,both,,,,25,12.5,,,,,,,,,,,,
COVID Vax Moderna 1stD w/Ad SS,11258943,CDM,0011A,HCPCS,Facility,both,,,,25,12.5,,,,,,,,,,,,
COVID Vax Pfizer 2nd d w/Ad SS,11258944,CDM,,,Facility,both,,,,25,12.5,,,,,,,,,,,,
COVID Vax Pfizer 1st d w/Ad SS,11258945,CDM,,,Facility,both,,,,25,12.5,,,,,,,,,,,,
Private Room & Bed Psychiatric,11400010,CDM,,,Facility,both,,,,2949,1474.5,,,,,,,,,,,,
Private Room & Bed Rehab,11800010,CDM,,,Facility,both,,,,2949,1474.5,,,,,,,,,,,,
Semi-Private Room & Bed,12000010,CDM,,,Facility,both,,,,2949,1474.5,,,,,,,,,,,,
Semi-Private Room - Nursing Hm,12000015,CDM,,,Facility,both,,,,2949,1474.5,,,,,,,,,,,,
Semi-Private Room MedSurg 2N,12100010,CDM,,,Facility,both,,,,2949,1474.5,,,,,,,,,,,,
SEMI-PRIVATE ROOM  MEDSURG 1W,12100011,CDM,,,Facility,both,,,,2949,1474.5,,,,,,,,,,,,
Semi-Private Room & Bed Psych,12400010,CDM,,,Facility,both,,,,2949,1474.5,,,,,,,,,,,,
Semi-Private Room & Bed Rehab,12800010,CDM,,,Facility,both,,,,2949,1474.5,,,,,,,,,,,,
Home Leave of Absense,18500010,CDM,,,Facility,both,,,,200,100,,,,,,,,,,,,
No Show Charge,22000010,CDM,,,Facility,both,,,,25,25,,,,,,,,,,,,
Cement Palacos R + G,27000010,CDM,,,Facility,both,,,,10,5,,,,,,,,,,,,
Blade Flacon,27000015,CDM,,,Facility,both,,,,10,5,,,,,,,,,,,,
Pack Total Knee,27000020,CDM,,,Facility,both,,,,10,5,,,,,,,,,,,,
Blade Clipper 3M,27000025,CDM,,,Facility,both,,,,10,5,,,,,,,,,,,,
Trocar With Sleeve,27000030,CDM,,,Facility,both,,,,10,5,,,,,,,,,,,,
ESU (Electrical Surgical Unit),27000035,CDM,,,Facility,both,,,,50,25,,,,,,,,,,,,
Finger Sticks,27000040,CDM,,,Facility,both,,,,10,5,,,,,,,,,,,,
Oxygen Delivery,27000045,CDM,,,Facility,both,,,,50,25,,,,,,,,,,,,
SOL BETADINE 4 OZ,27013142,CDM,,,Facility,both,,,,8,4,,,,,,,,,,,,
SPRAY BETADINE 3 OZ,27013144,CDM,,,Facility,both,,,,7,3.5,,,,,,,,,,,,
ABD BINDER UNIV 10+C71,27013155,CDM,,,Facility,both,,,,42,21,,,,,,,,,,,,
SUCTION CANNISTER 1200 CC,27013200,CDM,,,Facility,both,,,,70,35,,,,,,,,,,,,
SWAB STERILE GYN/OB,80002577,CDM,,,Facility,both,,,,9,4.5,,,,,,,,,,,,